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 $75.86 Median $91.20 Typical High $125.89 | Facility | None | $75.86 | $91.20 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $79.43 Typical High $91.20 | Professional | None | $75.86 | $79.43 | $91.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $79.43 Median $102.33 Typical High $263.03 | Facility | None | $79.43 | $102.33 | $263.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $91.20 Typical High $91.20 | Professional | None | $75.86 | $91.20 | $91.20 |
BCBS Kansas City Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $158.49 | Professional | None | $85.11 | $85.11 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $169.82 Typical High $194.98 | Facility | None | $95.50 | $169.82 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $89.13 Typical High $363.08 | Facility | None | $70.79 | $89.13 | $363.08 |
Medica Setting Professional Modifier None Typical Low $67.61 Median $79.43 Typical High $83.18 | Professional | None | $67.61 | $79.43 | $83.18 |
United Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
United Setting Professional Modifier None Typical Low $67.61 Median $79.43 Typical High $89.13 | Professional | None | $67.61 | $79.43 | $89.13 |
6 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 $38.02 Median $39.81 Typical High $45.71 | Professional | 52 · Reduced service | $38.02 | $39.81 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.85 Typical High $18.20 | Professional | 53 · Discontinued | $15.14 | $15.85 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $58.88 Typical High $69.18 | Professional | 54 · Surgery only | $57.54 | $58.88 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.75 Typical High $13.80 | Professional | 55 · Aftercare only | $11.48 | $11.75 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.94 Typical High $9.12 | Professional | 56 · Pre-op care only | $7.59 | $7.94 | $9.12 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | JZ · No drug discarded | $75.86 | $75.86 | $75.86 |
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
$79.43
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.