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 $30.90 Median $33.88 Typical High $53.70 | Facility | None | $30.90 | $33.88 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $33.88 Typical High $39.81 | Professional | None | $33.11 | $33.88 | $39.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $33.11 Median $44.67 Typical High $109.65 | Facility | None | $33.11 | $44.67 | $109.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $31.62 Median $38.90 Typical High $38.90 | Professional | None | $31.62 | $38.90 | $38.90 |
BCBS Kansas City Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $69.18 | Professional | None | $36.31 | $36.31 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $40.74 Typical High $95.50 | Facility | None | $37.15 | $40.74 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Medica Setting Facility Modifier None Typical Low $26.92 Median $33.88 Typical High $144.54 | Facility | None | $26.92 | $33.88 | $144.54 |
Medica Setting Professional Modifier None Typical Low $30.20 Median $125.89 Typical High $125.89 | Professional | None | $30.20 | $125.89 | $125.89 |
United Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
United Setting Professional Modifier None Typical Low $28.18 Median $33.11 Typical High $36.31 | Professional | None | $28.18 | $33.11 | $36.31 |
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 $16.60 Median $16.98 Typical High $19.95 | Professional | 52 · Reduced service | $16.60 | $16.98 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.76 Typical High $7.94 | Professional | 53 · Discontinued | $6.61 | $6.76 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $5.13 Typical High $5.89 | Professional | 55 · Aftercare only | $4.90 | $5.13 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.39 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.31 | $3.39 | $3.98 |
Ambetter Setting Professional Modifier JW · Drug discarded Typical Low $31.62 Median $31.62 Typical High $33.11 | Professional | JW · Drug discarded | $31.62 | $31.62 | $33.11 |
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· 50th of 51
$33.11
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.