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 $53.70 Median $69.18 Typical High $95.50 | Facility | None | $53.70 | $69.18 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $57.54 Typical High $69.18 | Professional | None | $56.23 | $57.54 | $69.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $56.23 Median $75.86 Typical High $186.21 | Facility | None | $56.23 | $75.86 | $186.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $66.07 Typical High $70.79 | Professional | None | $54.95 | $66.07 | $70.79 |
BCBS Kansas City Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $120.23 | Professional | None | $61.66 | $61.66 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $125.89 Typical High $144.54 | Facility | None | $70.79 | $125.89 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
Medica Setting Facility Modifier None Typical Low $46.77 Median $56.23 Typical High $239.88 | Facility | None | $46.77 | $56.23 | $239.88 |
Medica Setting Professional Modifier None Typical Low $50.12 Median $218.78 Typical High $218.78 | Professional | None | $50.12 | $218.78 | $218.78 |
United Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
United Setting Professional Modifier None Typical Low $47.86 Median $56.23 Typical High $63.10 | Professional | None | $47.86 | $56.23 | $63.10 |
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 $28.18 Median $28.84 Typical High $34.67 | Professional | 52 · Reduced service | $28.18 | $28.84 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.75 Typical High $13.80 | Professional | 53 · Discontinued | $11.22 | $11.75 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.71 Typical High $10.23 | Professional | 55 · Aftercare only | $8.51 | $8.71 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.75 Typical High $6.92 | Professional | 56 · Pre-op care only | $5.62 | $5.75 | $6.92 |
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· 14th of 51
$56.23
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.