How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $29.51 Median $37.15 Typical High $44.67 | Facility | None | $29.51 | $37.15 | $44.67 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $37.15 | Professional | None | $29.51 | $29.51 | $37.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.02 Median $0.02 Typical High $0.03 | Facility | None | $0.02 | $0.02 | $0.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $27.54 Median $37.15 Typical High $37.15 | Professional | None | $27.54 | $37.15 | $37.15 |
BCBS Kansas City Setting Professional Modifier None Typical Low $36.31 Median $63.10 Typical High $63.10 | Professional | None | $36.31 | $63.10 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $74.13 Typical High $81.28 | Facility | None | $38.90 | $74.13 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Medica Setting Facility Modifier None Typical Low $19.50 Median $52.48 Typical High $169.82 | Facility | None | $19.50 | $52.48 | $169.82 |
Medica Setting Professional Modifier None Typical Low $27.54 Median $32.36 Typical High $36.31 | Professional | None | $27.54 | $32.36 | $36.31 |
United Setting Professional Modifier None Typical Low $27.54 Median $32.36 Typical High $36.31 | Professional | None | $27.54 | $32.36 | $36.31 |
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 $14.79 Median $14.79 Typical High $18.62 | Professional | 52 · Reduced service | $14.79 | $14.79 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $7.41 | Professional | 53 · Discontinued | $5.89 | $5.89 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.47 Typical High $5.50 | Professional | 55 · Aftercare only | $4.47 | $4.47 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $2.95 Typical High $3.72 | Professional | 56 · Pre-op care only | $2.95 | $2.95 | $3.72 |
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· 32nd of 51
$31.62
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.