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 $4.79 Median $11.22 Typical High $11.22 | Facility | None | $4.79 | $11.22 | $11.22 |
Aetna Setting Professional Modifier None Typical Low $5.25 Median $11.22 Typical High $11.22 | Professional | None | $5.25 | $11.22 | $11.22 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.51 Median $11.22 Typical High $16.22 | Professional | None | $8.51 | $11.22 | $16.22 |
BCBS Kansas City Setting Professional Modifier None Typical Low $25.12 Median $26.92 Typical High $31.62 | Professional | None | $25.12 | $26.92 | $31.62 |
Cigna Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
Medica Setting Facility Modifier None Typical Low $6.03 Median $21.38 Typical High $89.13 | Facility | None | $6.03 | $21.38 | $89.13 |
Medica Setting Professional Modifier None Typical Low $6.31 Median $89.13 Typical High $89.13 | Professional | None | $6.31 | $89.13 | $89.13 |
United Setting Professional Modifier None Typical Low $4.57 Median $6.46 Typical High $12.02 | Professional | None | $4.57 | $6.46 | $12.02 |
2 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 55 · Aftercare only Typical Low $0.78 Median $1.70 Typical High $1.70 | Professional | 55 · Aftercare only | $0.78 | $1.70 | $1.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $1.12 Typical High $1.12 | Professional | 56 · Pre-op care only | $0.52 | $1.12 | $1.12 |
Where Missouri sits
The same service costs 95.5 times more in New York than in Kentucky. 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· 18th of 51
$10.47
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.