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 $199.53 Median $213.80 Typical High $331.13 | Facility | None | $199.53 | $213.80 | $331.13 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $213.80 Typical High $245.47 | Professional | None | $204.17 | $213.80 | $245.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $213.80 Median $275.42 Typical High $707.95 | Facility | None | $213.80 | $275.42 | $707.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $234.42 Typical High $234.42 | Professional | None | $204.17 | $234.42 | $234.42 |
BCBS Kansas City Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $407.38 | Professional | None | $223.87 | $223.87 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $251.19 Typical High $602.56 | Facility | None | $234.42 | $251.19 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Medica Setting Facility Modifier None Typical Low $186.21 Median $239.88 Typical High $977.24 | Facility | None | $186.21 | $239.88 | $977.24 |
Medica Setting Professional Modifier None Typical Low $199.53 Median $851.14 Typical High $851.14 | Professional | None | $199.53 | $851.14 | $851.14 |
United Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $229.09 | Professional | None | $181.97 | $213.80 | $229.09 |
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 $102.33 Median $104.71 Typical High $117.49 | Professional | 52 · Reduced service | $102.33 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $42.66 Typical High $46.77 | Professional | 53 · Discontinued | $40.74 | $42.66 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $31.62 Typical High $35.48 | Professional | 55 · Aftercare only | $30.90 | $31.62 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $21.38 Typical High $23.44 | Professional | 56 · Pre-op care only | $20.42 | $21.38 | $23.44 |
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· 12th of 51
$214
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.