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 $81.28 Median $97.72 Typical High $134.90 | Facility | None | $81.28 | $97.72 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $89.13 Typical High $102.33 | Professional | None | $85.11 | $89.13 | $102.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $87.10 Median $114.82 Typical High $288.40 | Facility | None | $87.10 | $114.82 | $288.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $97.72 | Professional | None | $83.18 | $97.72 | $97.72 |
BCBS Kansas City Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $165.96 | Professional | None | $93.33 | $93.33 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $190.55 Typical High $218.78 | Facility | None | $107.15 | $190.55 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Medica Setting Facility Modifier None Typical Low $74.13 Median $95.50 Typical High $338.84 | Facility | None | $74.13 | $95.50 | $338.84 |
Medica Setting Professional Modifier None Typical Low $81.28 Median $338.84 Typical High $338.84 | Professional | None | $81.28 | $338.84 | $338.84 |
United Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
United Setting Professional Modifier None Typical Low $74.13 Median $87.10 Typical High $95.50 | Professional | None | $74.13 | $87.10 | $95.50 |
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 $42.66 Median $44.67 Typical High $51.29 | Professional | 52 · Reduced service | $42.66 | $44.67 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $17.78 Typical High $20.42 | Professional | 53 · Discontinued | $16.98 | $17.78 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $13.18 Typical High $15.49 | Professional | 55 · Aftercare only | $12.88 | $13.18 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.91 Typical High $10.23 | Professional | 56 · Pre-op care only | $8.51 | $8.91 | $10.23 |
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· 19th of 51
$87.10
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.