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 $28.84 Median $38.02 Typical High $53.70 | Facility | None | $28.84 | $38.02 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $29.51 Typical High $38.02 | Professional | None | $28.84 | $29.51 | $38.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $30.20 Median $43.65 Typical High $100.00 | Facility | None | $30.20 | $43.65 | $100.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $28.84 Median $35.48 Typical High $38.02 | Professional | None | $28.84 | $35.48 | $38.02 |
BCBS Kansas City Setting Professional Modifier None Typical Low $37.15 Median $64.57 Typical High $64.57 | Professional | None | $37.15 | $64.57 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $77.62 Typical High $83.18 | Facility | None | $40.74 | $77.62 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Medica Setting Facility Modifier None Typical Low $28.84 Median $43.65 Typical High $144.54 | Facility | None | $28.84 | $43.65 | $144.54 |
Medica Setting Professional Modifier None Typical Low $28.84 Median $144.54 Typical High $144.54 | Professional | None | $28.84 | $144.54 | $144.54 |
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 $33.11 | Professional | None | $25.70 | $30.20 | $33.11 |
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 $14.13 Median $14.79 Typical High $19.05 | Professional | 52 · Reduced service | $14.13 | $14.79 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.89 Typical High $7.76 | Professional | 53 · Discontinued | $5.75 | $5.89 | $7.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.37 Typical High $5.75 | Professional | 55 · Aftercare only | $4.27 | $4.37 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.95 Typical High $3.80 | Professional | 56 · Pre-op care only | $2.82 | $2.95 | $3.80 |
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· 16th of 51
$32.36
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.