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 $28.18 Median $43.65 Typical High $181.97 | Facility | None | $28.18 | $43.65 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $35.48 Typical High $181.97 | Professional | None | $33.88 | $35.48 | $181.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $30.20 Median $45.71 Typical High $100.00 | Facility | None | $30.20 | $45.71 | $100.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $28.84 Median $36.31 Typical High $190.55 | Professional | None | $28.84 | $36.31 | $190.55 |
BCBS Kansas City Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $42.66 Median $81.28 Typical High $100.00 | Facility | None | $42.66 | $81.28 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Medica Setting Facility Modifier None Typical Low $28.18 Median $97.72 Typical High $275.42 | Facility | None | $28.18 | $97.72 | $275.42 |
Medica Setting Professional Modifier None Typical Low $25.70 Median $30.20 Typical High $35.48 | Professional | None | $25.70 | $30.20 | $35.48 |
United Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
United Setting Professional Modifier None Typical Low $25.70 Median $30.20 Typical High $33.88 | Professional | None | $25.70 | $30.20 | $33.88 |
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 $16.98 Median $17.38 Typical High $89.13 | Professional | 52 · Reduced service | $16.98 | $17.38 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $7.08 Typical High $36.31 | Professional | 53 · Discontinued | $6.76 | $7.08 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.25 Typical High $26.92 | Professional | 55 · Aftercare only | $5.13 | $5.25 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.55 Typical High $18.20 | Professional | 56 · Pre-op care only | $3.39 | $3.55 | $18.20 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | JZ · No drug discarded | $39.81 | $39.81 | $39.81 |
Where Missouri sits
The same service costs 5.4 times more in Wyoming than in Arizona. 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· 36th of 51
$33.88
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.