How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $4.47 Median $53.70 Typical High $125.89 | Facility | None | $4.47 | $53.70 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $77.62 Typical High $125.89 | Professional | None | $3.02 | $77.62 | $125.89 |
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 $144.54 Typical High $204.17 | Professional | None | $120.23 | $144.54 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Medica Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
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 $1.51 Median $38.90 Typical High $63.10 | Professional | 52 · Reduced service | $1.51 | $38.90 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $25.70 Typical High $25.70 | Professional | 53 · Discontinued | $10.72 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $8.13 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $5.37 | $12.59 | $12.59 |
Where Missouri sits
The same service costs 83.2 times more in North Dakota than in Kansas. 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· 20th of 51
$110
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.