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 $33.11 Median $38.90 Typical High $47.86 | Facility | None | $33.11 | $38.90 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $38.90 Typical High $42.66 | Professional | None | $33.11 | $38.90 | $42.66 |
Ambetter Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.79 Median $21.38 Typical High $33.11 | Professional | None | $14.79 | $21.38 | $33.11 |
BCBS Kansas City Setting Professional Modifier None Typical Low $22.91 Median $32.36 Typical High $42.66 | Professional | None | $22.91 | $32.36 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
Medica Setting Facility Modifier None Typical Low $25.12 Median $48.98 Typical High $138.04 | Facility | None | $25.12 | $48.98 | $138.04 |
Medica Setting Professional Modifier None Typical Low $28.18 Median $173.78 Typical High $199.53 | Professional | None | $28.18 | $173.78 | $199.53 |
United Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Facility | None | $21.88 | $21.88 | $21.88 |
United Setting Professional Modifier None Typical Low $24.55 Median $30.90 Typical High $50.12 | Professional | None | $24.55 | $30.90 | $50.12 |
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 $16.60 Median $19.50 Typical High $21.38 | Professional | 52 · Reduced service | $16.60 | $19.50 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $7.76 Typical High $8.71 | Professional | 53 · Discontinued | $6.76 | $7.76 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.89 Typical High $6.46 | Professional | 55 · Aftercare only | $5.01 | $5.89 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.89 Typical High $4.27 | Professional | 56 · Pre-op care only | $3.39 | $3.89 | $4.27 |
Where Missouri sits
The same service costs 3.8 times more in Alaska than in Indiana. 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· 41st of 51
$29.51
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.