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 $54.95 Median $74.13 Typical High $104.71 | Facility | None | $54.95 | $74.13 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $58.88 Typical High $74.13 | Professional | None | $57.54 | $58.88 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $57.54 Median $77.62 Typical High $190.55 | Facility | None | $57.54 | $77.62 | $190.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $69.18 Typical High $74.13 | Professional | None | $56.23 | $69.18 | $74.13 |
BCBS Kansas City Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $128.82 | Professional | None | $63.10 | $63.10 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $125.89 Typical High $147.91 | Facility | None | $72.44 | $125.89 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
Medica Setting Facility Modifier None Typical Low $50.12 Median $60.26 Typical High $263.03 | Facility | None | $50.12 | $60.26 | $263.03 |
Medica Setting Professional Modifier None Typical Low $54.95 Median $229.09 Typical High $229.09 | Professional | None | $54.95 | $229.09 | $229.09 |
United Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
United Setting Professional Modifier None Typical Low $48.98 Median $57.54 Typical High $64.57 | Professional | None | $48.98 | $57.54 | $64.57 |
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 $28.84 Median $29.51 Typical High $37.15 | Professional | 52 · Reduced service | $28.84 | $29.51 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.75 Typical High $15.14 | Professional | 53 · Discontinued | $11.48 | $11.75 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.71 Typical High $11.22 | Professional | 55 · Aftercare only | $8.51 | $8.71 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.89 Typical High $7.41 | Professional | 56 · Pre-op care only | $5.75 | $5.89 | $7.41 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $54.95 Median $57.54 Typical High $66.07 | Professional | JZ · No drug discarded | $54.95 | $57.54 | $66.07 |
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· 11th of 51
$58.88
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.