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 $138.04 Median $169.82 Typical High $234.42 | Facility | None | $138.04 | $169.82 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $147.91 Typical High $173.78 | Professional | None | $144.54 | $147.91 | $173.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $144.54 Median $194.98 Typical High $478.63 | Facility | None | $144.54 | $194.98 | $478.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $141.25 Median $169.82 Typical High $169.82 | Professional | None | $141.25 | $169.82 | $169.82 |
BCBS Kansas City Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $295.12 | Professional | None | $158.49 | $158.49 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $316.23 Typical High $371.54 | Facility | None | $177.83 | $316.23 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $147.91 Typical High $660.69 | Facility | None | $123.03 | $147.91 | $660.69 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $588.84 Typical High $588.84 | Professional | None | $134.90 | $588.84 | $588.84 |
United Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
United Setting Professional Modifier None Typical Low $123.03 Median $144.54 Typical High $162.18 | Professional | None | $123.03 | $144.54 | $162.18 |
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 $72.44 Median $74.13 Typical High $87.10 | Professional | 52 · Reduced service | $72.44 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $29.51 Typical High $34.67 | Professional | 53 · Discontinued | $28.84 | $29.51 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $22.39 Typical High $25.70 | Professional | 55 · Aftercare only | $21.38 | $22.39 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.79 Typical High $17.38 | Professional | 56 · Pre-op care only | $14.45 | $14.79 | $17.38 |
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· 37th of 51
$145
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.