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 $223.87 Median $257.04 Typical High $354.81 | Facility | None | $223.87 | $257.04 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $234.42 Typical High $269.15 | Professional | None | $229.09 | $234.42 | $269.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $234.42 Median $309.03 Typical High $776.25 | Facility | None | $234.42 | $309.03 | $776.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $257.04 Typical High $257.04 | Professional | None | $229.09 | $257.04 | $257.04 |
BCBS Kansas City Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $446.68 | Professional | None | $251.19 | $251.19 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $501.19 Typical High $588.84 | Facility | None | $281.84 | $501.19 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Medica Setting Facility Modifier None Typical Low $208.93 Median $263.03 Typical High $1,071.52 | Facility | None | $208.93 | $263.03 | $1,071.52 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $954.99 Typical High $954.99 | Professional | None | $218.78 | $954.99 | $954.99 |
United Setting Professional Modifier None Typical Low $199.53 Median $234.42 Typical High $257.04 | Professional | None | $199.53 | $234.42 | $257.04 |
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 $114.82 Median $117.49 Typical High $134.90 | Professional | 52 · Reduced service | $114.82 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $46.77 Typical High $53.70 | Professional | 53 · Discontinued | $45.71 | $46.77 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $35.48 Typical High $40.74 | Professional | 55 · Aftercare only | $33.88 | $35.48 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $23.44 Typical High $26.92 | Professional | 56 · Pre-op care only | $22.91 | $23.44 | $26.92 |
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· 15th of 51
$234
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.