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 $24.55 Median $38.02 Typical High $97.72 | Facility | None | $24.55 | $38.02 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $29.51 Typical High $79.43 | Professional | None | $28.84 | $29.51 | $79.43 |
Anthem BCBS Setting Facility Modifier None Typical Low $28.84 Median $38.90 Typical High $75.86 | Facility | None | $28.84 | $38.90 | $75.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.12 Median $31.62 Typical High $79.43 | Professional | None | $25.12 | $31.62 | $79.43 |
BCBS Kansas City Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $134.90 | Professional | None | $31.62 | $31.62 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $67.61 Typical High $79.43 | Facility | None | $36.31 | $67.61 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Medica Setting Facility Modifier None Typical Low $19.95 Median $38.90 Typical High $81.28 | Facility | None | $19.95 | $38.90 | $81.28 |
Medica Setting Professional Modifier None Typical Low $17.78 Median $20.89 Typical High $28.18 | Professional | None | $17.78 | $20.89 | $28.18 |
United Setting Professional Modifier None Typical Low $22.39 Median $26.30 Typical High $29.51 | Professional | None | $22.39 | $26.30 | $29.51 |
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 $14.45 Median $14.79 Typical High $39.81 | Professional | 52 · Reduced service | $14.45 | $14.79 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.89 Typical High $15.85 | Professional | 53 · Discontinued | $5.75 | $5.89 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.47 Typical High $12.02 | Professional | 55 · Aftercare only | $4.37 | $4.47 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.95 Typical High $7.94 | Professional | 56 · Pre-op care only | $2.88 | $2.95 | $7.94 |
Where Missouri sits
The same service costs 2.8 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· 12th of 51
$28.84
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.