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 $36.31 Median $41.69 Typical High $58.88 | Facility | None | $36.31 | $41.69 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $38.02 Typical High $43.65 | Professional | None | $36.31 | $38.02 | $43.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $38.90 Median $50.12 Typical High $128.82 | Facility | None | $38.90 | $50.12 | $128.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $36.31 Median $41.69 Typical High $42.66 | Professional | None | $36.31 | $41.69 | $42.66 |
BCBS Kansas City Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $72.44 | Professional | None | $40.74 | $40.74 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $44.67 Typical High $107.15 | Facility | None | $41.69 | $44.67 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Medica Setting Facility Modifier None Typical Low $35.48 Median $42.66 Typical High $181.97 | Facility | None | $35.48 | $42.66 | $181.97 |
Medica Setting Professional Modifier None Typical Low $36.31 Median $162.18 Typical High $162.18 | Professional | None | $36.31 | $162.18 | $162.18 |
United Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
United Setting Professional Modifier None Typical Low $33.11 Median $38.90 Typical High $41.69 | Professional | None | $33.11 | $38.90 | $41.69 |
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 $18.20 Median $19.05 Typical High $21.88 | Professional | 52 · Reduced service | $18.20 | $19.05 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.59 Typical High $8.71 | Professional | 53 · Discontinued | $7.41 | $7.59 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.62 Typical High $6.61 | Professional | 55 · Aftercare only | $5.50 | $5.62 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.80 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.63 | $3.80 | $4.37 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | JZ · No drug discarded | $36.31 | $36.31 | $36.31 |
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· 12th of 51
$38.90
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.