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 $165.96 Median $223.87 Typical High $537.03 | Facility | None | $165.96 | $223.87 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $165.96 Typical High $537.03 | Professional | None | $162.18 | $165.96 | $537.03 |
Ambetter Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $173.78 Median $239.88 Typical High $616.60 | Facility | None | $173.78 | $239.88 | $616.60 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $218.78 Typical High $537.03 | Professional | None | $162.18 | $218.78 | $537.03 |
BCBS Kansas City Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $912.01 | Professional | None | $177.83 | $177.83 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $380.19 Typical High $467.74 | Facility | None | $204.17 | $380.19 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
Medica Setting Facility Modifier None Typical Low $154.88 Median $467.74 Typical High $1,412.54 | Facility | None | $154.88 | $467.74 | $1,412.54 |
Medica Setting Professional Modifier None Typical Low $141.25 Median $165.96 Typical High $186.21 | Professional | None | $141.25 | $165.96 | $186.21 |
United Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
United Setting Professional Modifier None Typical Low $158.49 Median $186.21 Typical High $208.93 | Professional | None | $158.49 | $186.21 | $208.93 |
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 $79.43 Median $83.18 Typical High $269.15 | Professional | 52 · Reduced service | $79.43 | $83.18 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $33.11 Typical High $109.65 | Professional | 53 · Discontinued | $32.36 | $33.11 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $24.55 Typical High $81.28 | Professional | 55 · Aftercare only | $23.99 | $24.55 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $16.60 Typical High $53.70 | Professional | 56 · Pre-op care only | $15.85 | $16.60 | $53.70 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | JZ · No drug discarded | $162.18 | $162.18 | $162.18 |
Where Missouri sits
The same service costs 1.9 times more in Wyoming than in Nevada. 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· 11th of 51
$178
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.