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 $16.60 Median $25.70 Typical High $56.23 | Facility | None | $16.60 | $25.70 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $25.70 Typical High $46.77 | Professional | None | $25.12 | $25.70 | $46.77 |
Anthem BCBS Setting Facility Modifier None Typical Low $22.39 Median $28.84 Typical High $66.07 | Facility | None | $22.39 | $28.84 | $66.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.98 Median $25.12 Typical High $46.77 | Professional | None | $16.98 | $25.12 | $46.77 |
BCBS Kansas City Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $79.43 | Professional | None | $27.54 | $27.54 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $31.62 Median $54.95 Typical High $63.10 | Facility | None | $31.62 | $54.95 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Medica Setting Facility Modifier None Typical Low $22.39 Median $40.74 Typical High $75.86 | Facility | None | $22.39 | $40.74 | $75.86 |
Medica Setting Professional Modifier None Typical Low $18.62 Median $22.39 Typical High $74.13 | Professional | None | $18.62 | $22.39 | $74.13 |
United Setting Professional Modifier None Typical Low $14.79 Median $17.78 Typical High $70.79 | Professional | None | $14.79 | $17.78 | $70.79 |
5 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 $12.30 Median $12.88 Typical High $23.44 | Professional | 52 · Reduced service | $12.30 | $12.88 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.13 Typical High $9.33 | Professional | 53 · Discontinued | $5.01 | $5.13 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.80 Typical High $7.08 | Professional | 55 · Aftercare only | $3.72 | $3.80 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.57 Typical High $4.68 | Professional | 56 · Pre-op care only | $2.45 | $2.57 | $4.68 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $16.60 Median $16.60 Typical High $33.88 | Professional | JZ · No drug discarded | $16.60 | $16.60 | $33.88 |
Where Missouri sits
The same service costs 1.9 times more in Wyoming than in Arizona. 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· 31st of 51
$25.12
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.