How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $47.86 Median $112.20 Typical High $112.20 | Facility | None | $47.86 | $112.20 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $112.20 Typical High $707.95 | Professional | None | $47.86 | $112.20 | $707.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $138.04 | Professional | None | $97.72 | $109.65 | $138.04 |
BCBS Kansas City Setting Professional Modifier None Typical Low $120.23 Median $138.04 Typical High $177.83 | Professional | None | $120.23 | $138.04 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $223.87 Typical High $302.00 | Facility | None | $144.54 | $223.87 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Medica Setting Facility Modifier None Typical Low $60.26 Median $1,819.70 Typical High $5,011.87 | Facility | None | $60.26 | $1,819.70 | $5,011.87 |
Medica Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $4,897.79 | Professional | None | $1,445.44 | $1,445.44 | $4,897.79 |
United Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $147.91 | Professional | None | $114.82 | $125.89 | $147.91 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $56.23 Typical High $354.81 | Professional | 52 · Reduced service | $23.99 | $56.23 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $22.39 Typical High $141.25 | Professional | 53 · Discontinued | $9.55 | $22.39 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $16.98 Typical High $107.15 | Professional | 55 · Aftercare only | $7.24 | $16.98 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $11.22 Typical High $70.79 | Professional | 56 · Pre-op care only | $4.79 | $11.22 | $70.79 |
Where Missouri sits
The same service costs 26.9 times more in Kansas than in New York. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Missouri· 31st of 51
$126
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.