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 $1.78 Median $2.04 Typical High $2.45 | Facility | None | $1.78 | $2.04 | $2.45 |
Aetna Setting Professional Modifier None Typical Low $2.00 Median $2.04 Typical High $2.40 | Professional | None | $2.00 | $2.04 | $2.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.00 Median $2.69 Typical High $5.25 | Facility | None | $2.00 | $2.69 | $5.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.82 Median $2.19 Typical High $2.40 | Professional | None | $1.82 | $2.19 | $2.40 |
BCBS Kansas City Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $4.07 | Professional | None | $2.19 | $2.19 | $4.07 |
Cigna Setting Facility Modifier None Typical Low $2.51 Median $4.47 Typical High $5.13 | Facility | None | $2.51 | $4.47 | $5.13 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | None | $2.00 | $2.00 | $2.00 |
Medica Setting Facility Modifier None Typical Low $1.38 Median $1.58 Typical High $2.51 | Facility | None | $1.38 | $1.58 | $2.51 |
Medica Setting Professional Modifier None Typical Low $1.45 Median $1.70 Typical High $1.86 | Professional | None | $1.45 | $1.70 | $1.86 |
United Setting Professional Modifier None Typical Low $1.58 Median $1.86 Typical High $2.09 | Professional | None | $1.58 | $1.86 | $2.09 |
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 $1.00 Median $1.02 Typical High $1.20 | Professional | 52 · Reduced service | $1.00 | $1.02 | $1.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.40 Median $0.41 Typical High $0.48 | Professional | 53 · Discontinued | $0.40 | $0.41 | $0.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.30 Median $0.31 Typical High $0.36 | Professional | 55 · Aftercare only | $0.30 | $0.31 | $0.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.21 Typical High $0.24 | Professional | 56 · Pre-op care only | $0.20 | $0.21 | $0.24 |
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· 44th of 51
$2.00
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.