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 $60.26 Median $131.83 Typical High $186.21 | Facility | None | $60.26 | $131.83 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $61.66 Typical High $154.88 | Professional | None | $60.26 | $61.66 | $154.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $66.07 Median $102.33 Typical High $269.15 | Facility | None | $66.07 | $102.33 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $95.50 Typical High $102.33 | Professional | None | $60.26 | $95.50 | $102.33 |
BCBS Kansas City Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $173.78 | Professional | None | $66.07 | $66.07 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $131.83 Typical High $154.88 | Facility | None | $75.86 | $131.83 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $141.25 Typical High $588.84 | Facility | None | $104.71 | $141.25 | $588.84 |
Medica Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $125.89 | Professional | None | $93.33 | $109.65 | $125.89 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
United Setting Professional Modifier None Typical Low $69.18 Median $81.28 Typical High $91.20 | Professional | None | $69.18 | $81.28 | $91.20 |
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 $30.20 Median $30.90 Typical High $77.62 | Professional | 52 · Reduced service | $30.20 | $30.90 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.30 Typical High $30.90 | Professional | 53 · Discontinued | $12.02 | $12.30 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.33 Typical High $22.91 | Professional | 55 · Aftercare only | $8.91 | $9.33 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.17 Typical High $15.49 | Professional | 56 · Pre-op care only | $6.03 | $6.17 | $15.49 |
Where Missouri sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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· 9th of 51
$81.28
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.