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 $97.72 Median $97.72 Typical High $138.04 | Facility | None | $97.72 | $97.72 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $97.72 Typical High $97.72 | Professional | None | $91.20 | $97.72 | $97.72 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.71 Median $11.75 Typical High $91.20 | Professional | None | $8.71 | $11.75 | $91.20 |
BCBS Kansas City Setting Professional Modifier None Typical Low $100.00 Median $107.15 Typical High $151.36 | Professional | None | $100.00 | $107.15 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Medica Setting Facility Modifier None Typical Low $95.50 Median $181.97 Typical High $501.19 | Facility | None | $95.50 | $181.97 | $501.19 |
Medica Setting Professional Modifier None Typical Low $74.13 Median $120.23 Typical High $602.56 | Professional | None | $74.13 | $120.23 | $602.56 |
Qualchoice Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
United Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
United Setting Professional Modifier None Typical Low $74.13 Median $91.20 Typical High $128.82 | Professional | None | $74.13 | $91.20 | $128.82 |
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 $45.71 Median $48.98 Typical High $48.98 | Professional | 52 · Reduced service | $45.71 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $19.50 Typical High $19.50 | Professional | 53 · Discontinued | $18.62 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $14.45 Typical High $14.79 | Professional | 55 · Aftercare only | $13.80 | $14.45 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.77 Typical High $9.77 | Professional | 56 · Pre-op care only | $9.12 | $9.77 | $9.77 |
Where Missouri sits
The same service costs 3.3 times more in Alaska 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· 50th of 51
$74.13
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.