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 $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.02 Median $0.02 Typical High $0.03 | Facility | None | $0.02 | $0.02 | $0.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.89 Median $26.30 Typical High $26.30 | Professional | None | $20.89 | $26.30 | $26.30 |
Cigna Setting Facility Modifier None Typical Low $23.99 Median $34.67 Typical High $38.90 | Facility | None | $23.99 | $34.67 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Medica Setting Facility Modifier None Typical Low $20.89 Median $39.81 Typical High $109.65 | Facility | None | $20.89 | $39.81 | $109.65 |
Medica Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $24.55 | Professional | None | $20.89 | $20.89 | $24.55 |
United Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $23.99 | Professional | None | $20.89 | $20.89 | $23.99 |
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 $10.47 Median $10.47 Typical High $10.47 | Professional | 52 · Reduced service | $10.47 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | 53 · Discontinued | $4.17 | $4.17 | $4.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | 55 · Aftercare only | $3.16 | $3.16 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | 56 · Pre-op care only | $2.09 | $2.09 | $2.09 |
Where Missouri sits
The same service costs 1.9 times more in Kansas than in Connecticut. 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
$20.89
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.