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 $14.13 Median $33.11 Typical High $33.11 | Facility | None | $14.13 | $33.11 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $20.42 Typical High $33.11 | Professional | None | $14.13 | $20.42 | $33.11 |
Ambetter Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $46.77 | Professional | None | $19.05 | $19.05 | $46.77 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.80 Median $19.05 Typical High $26.92 | Professional | None | $13.80 | $19.05 | $26.92 |
BCBS Kansas City Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $33.88 | Professional | None | $20.42 | $20.42 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | None | $13.80 | $13.80 | $13.80 |
Medica Setting Facility Modifier None Typical Low $17.78 Median $67.61 Typical High $154.88 | Facility | None | $17.78 | $67.61 | $154.88 |
Medica Setting Professional Modifier None Typical Low $11.75 Median $16.60 Typical High $338.84 | Professional | None | $11.75 | $16.60 | $338.84 |
United Setting Professional Modifier None Typical Low $10.96 Median $16.60 Typical High $26.92 | Professional | None | $10.96 | $16.60 | $26.92 |
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 $7.08 Median $10.00 Typical High $16.60 | Professional | 52 · Reduced service | $7.08 | $10.00 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $4.07 Typical High $6.61 | Professional | 53 · Discontinued | $2.82 | $4.07 | $6.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.72 Median $15.14 Typical High $25.12 | Professional | 54 · Surgery only | $10.72 | $15.14 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $3.02 Typical High $5.01 | Professional | 55 · Aftercare only | $2.14 | $3.02 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $2.04 Typical High $3.31 | Professional | 56 · Pre-op care only | $1.41 | $2.04 | $3.31 |
Where Missouri sits
The same service costs 2.6 times more in Hawaii 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· 35th of 51
$19.05
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.