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 $60.26 Median $75.86 Typical High $87.10 | Facility | None | $60.26 | $75.86 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $75.86 | Professional | None | $60.26 | $60.26 | $75.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $63.10 Median $85.11 Typical High $165.96 | Facility | None | $63.10 | $85.11 | $165.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $75.86 Typical High $75.86 | Professional | None | $56.23 | $75.86 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $104.71 Typical High $120.23 | Facility | None | $72.44 | $104.71 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Medica Setting Facility Modifier None Typical Low $57.54 Median $63.10 Typical High $162.18 | Facility | None | $57.54 | $63.10 | $162.18 |
Medica Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $75.86 | Professional | None | $63.10 | $63.10 | $75.86 |
United Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $77.62 | Professional | None | $63.10 | $63.10 | $77.62 |
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 $30.20 Median $30.20 Typical High $37.15 | Professional | 52 · Reduced service | $30.20 | $30.20 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $15.14 | Professional | 53 · Discontinued | $12.02 | $12.02 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $11.22 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $7.59 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $7.59 |
Where Missouri sits
The same service costs 3.2 times more in Kansas than in Arkansas. 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· 42nd of 51
$63.10
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.