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 $33.88 Median $38.02 Typical High $56.23 | Facility | None | $33.88 | $38.02 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $33.88 Typical High $38.90 | Professional | None | $32.36 | $33.88 | $38.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $33.88 Median $43.65 Typical High $114.82 | Facility | None | $33.88 | $43.65 | $114.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $32.36 Median $38.02 Typical High $38.02 | Professional | None | $32.36 | $38.02 | $38.02 |
BCBS Kansas City Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $64.57 | Professional | None | $35.48 | $35.48 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $39.81 Typical High $95.50 | Facility | None | $37.15 | $39.81 | $95.50 |
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 $32.36 Median $39.81 Typical High $162.18 | Facility | None | $32.36 | $39.81 | $162.18 |
Medica Setting Professional Modifier None Typical Low $32.36 Median $144.54 Typical High $144.54 | Professional | None | $32.36 | $144.54 | $144.54 |
United Setting Professional Modifier None Typical Low $29.51 Median $32.36 Typical High $32.36 | Professional | None | $29.51 | $32.36 | $32.36 |
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 $16.22 Median $16.60 Typical High $19.50 | Professional | 52 · Reduced service | $16.22 | $16.60 | $19.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.76 Typical High $7.76 | Professional | 53 · Discontinued | $6.46 | $6.76 | $7.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $5.01 Typical High $5.89 | Professional | 55 · Aftercare only | $4.90 | $5.01 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.39 Typical High $3.89 | Professional | 56 · Pre-op care only | $3.24 | $3.39 | $3.89 |
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· 19th 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.