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 $7.24 Median $10.47 Typical High $14.13 | Facility | None | $7.24 | $10.47 | $14.13 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $8.32 Typical High $11.75 | Professional | None | $8.13 | $8.32 | $11.75 |
Anthem BCBS Setting Facility Modifier None Typical Low $8.13 Median $10.96 Typical High $21.38 | Facility | None | $8.13 | $10.96 | $21.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.41 Median $9.12 Typical High $11.75 | Professional | None | $7.41 | $9.12 | $11.75 |
BCBS Kansas City Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $19.95 | Professional | None | $8.91 | $8.91 | $19.95 |
Cigna Setting Facility Modifier None Typical Low $9.33 Median $13.80 Typical High $19.05 | Facility | None | $9.33 | $13.80 | $19.05 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Medica Setting Facility Modifier None Typical Low $3.39 Median $9.55 Typical High $75.86 | Facility | None | $3.39 | $9.55 | $75.86 |
Medica Setting Professional Modifier None Typical Low $5.37 Median $48.98 Typical High $48.98 | Professional | None | $5.37 | $48.98 | $48.98 |
United Setting Professional Modifier None Typical Low $6.46 Median $7.24 Typical High $7.59 | Professional | None | $6.46 | $7.24 | $7.59 |
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 $4.07 Median $4.17 Typical High $5.75 | Professional | 52 · Reduced service | $4.07 | $4.17 | $5.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.66 Typical High $2.29 | Professional | 53 · Discontinued | $1.62 | $1.66 | $2.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.26 Typical High $1.74 | Professional | 55 · Aftercare only | $1.23 | $1.26 | $1.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.83 Typical High $1.15 | Professional | 56 · Pre-op care only | $0.81 | $0.83 | $1.15 |
Where Missouri sits
Rates are fairly even across states for this service. 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· 35th of 51
$8.13
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.