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 $38.02 Median $38.02 Typical High $46.77 | Facility | None | $38.02 | $38.02 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.90 Typical High $46.77 | Professional | None | $38.02 | $38.90 | $46.77 |
Anthem BCBS Setting Professional Modifier None Typical Low $22.91 Median $26.92 Typical High $44.67 | Professional | None | $22.91 | $26.92 | $44.67 |
BCBS Kansas City Setting Professional Modifier None Typical Low $38.02 Median $40.74 Typical High $43.65 | Professional | None | $38.02 | $40.74 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Medica Setting Facility Modifier None Typical Low $28.18 Median $77.62 Typical High $218.78 | Facility | None | $28.18 | $77.62 | $218.78 |
Medica Setting Professional Modifier None Typical Low $27.54 Median $35.48 Typical High $269.15 | Professional | None | $27.54 | $35.48 | $269.15 |
United Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $123.03 | Facility | None | $117.49 | $117.49 | $123.03 |
United Setting Professional Modifier None Typical Low $27.54 Median $30.20 Typical High $53.70 | Professional | None | $27.54 | $30.20 | $53.70 |
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 $19.05 Median $19.50 Typical High $23.44 | Professional | 52 · Reduced service | $19.05 | $19.50 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.76 Typical High $9.33 | Professional | 53 · Discontinued | $7.59 | $7.76 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $7.08 | Professional | 55 · Aftercare only | $5.75 | $5.75 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $4.68 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $4.68 |
Where Missouri sits
The same service costs 12.9 times more in Hawaii 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· 33rd of 51
$37.15
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.