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 $269.15 Median $316.23 Typical High $407.38 | Facility | None | $269.15 | $316.23 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $288.40 Typical High $338.84 | Professional | None | $281.84 | $288.40 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $281.84 Median $380.19 Typical High $933.25 | Facility | None | $281.84 | $380.19 | $933.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $316.23 Typical High $316.23 | Professional | None | $275.42 | $316.23 | $316.23 |
BCBS Kansas City Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $562.34 | Professional | None | $309.03 | $309.03 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $616.60 Typical High $724.44 | Facility | None | $346.74 | $616.60 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $263.03 Typical High $1,258.93 | Facility | None | $223.87 | $263.03 | $1,258.93 |
Medica Setting Professional Modifier None Typical Low $234.42 Median $263.03 Typical High $288.40 | Professional | None | $234.42 | $263.03 | $288.40 |
United Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
United Setting Professional Modifier None Typical Low $239.88 Median $281.84 Typical High $309.03 | Professional | None | $239.88 | $281.84 | $309.03 |
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 $138.04 Median $144.54 Typical High $165.96 | Professional | 52 · Reduced service | $138.04 | $144.54 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $57.54 Typical High $66.07 | Professional | 53 · Discontinued | $56.23 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $42.66 Typical High $50.12 | Professional | 55 · Aftercare only | $41.69 | $42.66 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.84 Typical High $33.11 | Professional | 56 · Pre-op care only | $28.18 | $28.84 | $33.11 |
Ambetter Setting Professional Modifier JW · Drug discarded Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | JW · Drug discarded | $281.84 | $281.84 | $281.84 |
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· 46th of 51
$282
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.