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 $213.80 Median $288.40 Typical High $389.05 | Facility | None | $213.80 | $288.40 | $389.05 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $316.23 Typical High $389.05 | Professional | None | $218.78 | $316.23 | $389.05 |
Ambetter Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $457.09 | Professional | None | $389.05 | $389.05 | $457.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $446.68 | Professional | None | $263.03 | $338.84 | $446.68 |
BCBS Kansas City Setting Professional Modifier None Typical Low $380.19 Median $501.19 Typical High $691.83 | Professional | None | $380.19 | $501.19 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Medica Setting Facility Modifier None Typical Low $295.12 Median $1,023.29 Typical High $2,041.74 | Facility | None | $295.12 | $1,023.29 | $2,041.74 |
Medica Setting Professional Modifier None Typical Low $380.19 Median $2,398.83 Typical High $2,754.23 | Professional | None | $380.19 | $2,398.83 | $2,754.23 |
United Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $588.84 | Facility | None | $562.34 | $562.34 | $588.84 |
United Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $630.96 | Professional | None | $269.15 | $371.54 | $630.96 |
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 $144.54 Median $194.98 Typical High $223.87 | Professional | 52 · Reduced service | $144.54 | $194.98 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $77.62 Typical High $89.13 | Professional | 53 · Discontinued | $57.54 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $57.54 Typical High $67.61 | Professional | 55 · Aftercare only | $42.66 | $57.54 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $38.90 Typical High $44.67 | Professional | 56 · Pre-op care only | $28.84 | $38.90 | $44.67 |
Where Missouri sits
The same service costs 2.1 times more in Wyoming than in Maryland. 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· 38th of 51
$372
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.