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 $15.49 Median $20.42 Typical High $36.31 | Facility | None | $15.49 | $20.42 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $15.49 Median $28.84 Typical High $67.61 | Professional | None | $15.49 | $28.84 | $67.61 |
Ambetter Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $15.14 Median $20.89 Typical High $29.51 | Professional | None | $15.14 | $20.89 | $29.51 |
BCBS Kansas City Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $37.15 | Professional | None | $22.39 | $22.39 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Medica Setting Facility Modifier None Typical Low $19.50 Median $74.13 Typical High $199.53 | Facility | None | $19.50 | $74.13 | $199.53 |
Medica Setting Professional Modifier None Typical Low $12.88 Median $18.20 Typical High $457.09 | Professional | None | $12.88 | $18.20 | $457.09 |
United Setting Professional Modifier None Typical Low $12.02 Median $18.20 Typical High $29.51 | Professional | None | $12.02 | $18.20 | $29.51 |
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 $7.76 Median $11.22 Typical High $18.20 | Professional | 52 · Reduced service | $7.76 | $11.22 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $4.47 Typical High $7.24 | Professional | 53 · Discontinued | $3.09 | $4.47 | $7.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $11.75 Median $16.60 Typical High $27.54 | Professional | 54 · Surgery only | $11.75 | $16.60 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $3.31 Typical High $5.50 | Professional | 55 · Aftercare only | $2.34 | $3.31 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $2.24 Typical High $3.63 | Professional | 56 · Pre-op care only | $1.55 | $2.24 | $3.63 |
Where Missouri sits
The same service costs 3.1 times more in Rhode Island than in New York. 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· 38th of 51
$20.89
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.