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 $37.15 Median $38.90 Typical High $60.26 | Facility | None | $37.15 | $38.90 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.90 Typical High $44.67 | Professional | None | $38.02 | $38.90 | $44.67 |
Anthem BCBS Setting Facility Modifier None Typical Low $38.90 Median $51.29 Typical High $128.82 | Facility | None | $38.90 | $51.29 | $128.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.02 Median $43.65 Typical High $43.65 | Professional | None | $38.02 | $43.65 | $43.65 |
BCBS Kansas City Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $75.86 | Professional | None | $41.69 | $41.69 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $42.66 Median $45.71 Typical High $109.65 | Facility | None | $42.66 | $45.71 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Medica Setting Facility Modifier None Typical Low $33.88 Median $40.74 Typical High $177.83 | Facility | None | $33.88 | $40.74 | $177.83 |
Medica Setting Professional Modifier None Typical Low $36.31 Median $154.88 Typical High $154.88 | Professional | None | $36.31 | $154.88 | $154.88 |
United Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
United Setting Professional Modifier None Typical Low $33.11 Median $38.90 Typical High $42.66 | Professional | None | $33.11 | $38.90 | $42.66 |
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 $18.62 Median $19.50 Typical High $22.39 | Professional | 52 · Reduced service | $18.62 | $19.50 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.76 Typical High $9.12 | Professional | 53 · Discontinued | $7.59 | $7.76 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.75 Typical High $6.76 | Professional | 55 · Aftercare only | $5.62 | $5.75 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.89 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.80 | $3.89 | $4.47 |
Ambetter Setting Professional Modifier JW · Drug discarded Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | JW · Drug discarded | $37.15 | $37.15 | $37.15 |
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· 13th of 51
$38.90
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.