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 $295.12 Median $295.12 Typical High $446.68 | Facility | None | $295.12 | $295.12 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $302.00 | Professional | None | $295.12 | $295.12 | $302.00 |
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 $281.84 Median $371.54 Typical High $371.54 | Professional | None | $281.84 | $371.54 | $371.54 |
BCBS Kansas City Setting Professional Modifier None Typical Low $354.81 Median $363.08 Typical High $562.34 | Professional | None | $354.81 | $363.08 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $776.25 Typical High $831.76 | Facility | None | $398.11 | $776.25 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Medica Setting Facility Modifier None Typical Low $162.18 Median $338.84 Typical High $1,659.59 | Facility | None | $162.18 | $338.84 | $1,659.59 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $1,258.93 Typical High $1,258.93 | Professional | None | $309.03 | $1,258.93 | $1,258.93 |
United Setting Professional Modifier None Typical Low $281.84 Median $331.13 Typical High $363.08 | Professional | None | $281.84 | $331.13 | $363.08 |
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 $147.91 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | 53 · Discontinued | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $29.51 |
Where Missouri sits
The same service costs 2.3 times more in Alaska than in Montana. 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· 6th of 51
$331
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.