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 $2.69 Median $3.80 Typical High $4.90 | Facility | None | $2.69 | $3.80 | $4.90 |
Aetna Setting Professional Modifier None Typical Low $2.95 Median $3.02 Typical High $4.07 | Professional | None | $2.95 | $3.02 | $4.07 |
Ambetter Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.95 Median $3.98 Typical High $7.76 | Facility | None | $2.95 | $3.98 | $7.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.75 Median $4.07 Typical High $5.89 | Professional | None | $2.75 | $4.07 | $5.89 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1.23 Median $3.24 Typical High $3.24 | Professional | None | $1.23 | $3.24 | $3.24 |
Cigna Setting Facility Modifier None Typical Low $3.72 Median $6.46 Typical High $7.59 | Facility | None | $3.72 | $6.46 | $7.59 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | None | $2.95 | $2.95 | $2.95 |
Medica Setting Facility Modifier None Typical Low $2.29 Median $2.45 Typical High $3.55 | Facility | None | $2.29 | $2.45 | $3.55 |
Medica Setting Professional Modifier None Typical Low $2.04 Median $2.40 Typical High $2.75 | Professional | None | $2.04 | $2.40 | $2.75 |
United Setting Professional Modifier None Typical Low $2.40 Median $2.82 Typical High $3.16 | Professional | None | $2.40 | $2.82 | $3.16 |
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 $1.48 Median $1.51 Typical High $2.04 | Professional | 52 · Reduced service | $1.48 | $1.51 | $2.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.59 Median $0.62 Typical High $0.81 | Professional | 53 · Discontinued | $0.59 | $0.62 | $0.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.44 Median $0.45 Typical High $0.60 | Professional | 55 · Aftercare only | $0.44 | $0.45 | $0.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.30 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.28 | $0.30 | $0.40 |
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· 16th of 51
$2.95
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.