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 $31.62 Median $74.13 Typical High $74.13 | Facility | None | $31.62 | $74.13 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $44.67 Typical High $74.13 | Professional | None | $31.62 | $44.67 | $74.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.20 Median $41.69 Typical High $60.26 | Professional | None | $30.20 | $41.69 | $60.26 |
BCBS Kansas City Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $75.86 | Professional | None | $44.67 | $44.67 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Medica Setting Facility Modifier None Typical Low $38.90 Median $151.36 Typical High $346.74 | Facility | None | $38.90 | $151.36 | $346.74 |
Medica Setting Professional Modifier None Typical Low $26.30 Median $37.15 Typical High $645.65 | Professional | None | $26.30 | $37.15 | $645.65 |
United Setting Professional Modifier None Typical Low $24.55 Median $36.31 Typical High $60.26 | Professional | None | $24.55 | $36.31 | $60.26 |
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 $15.85 Median $22.39 Typical High $37.15 | Professional | 52 · Reduced service | $15.85 | $22.39 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $8.91 Typical High $14.79 | Professional | 53 · Discontinued | $6.31 | $8.91 | $14.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.44 Median $33.88 Typical High $54.95 | Professional | 54 · Surgery only | $23.44 | $33.88 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $6.76 Typical High $10.96 | Professional | 55 · Aftercare only | $4.79 | $6.76 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $4.47 Typical High $7.41 | Professional | 56 · Pre-op care only | $3.16 | $4.47 | $7.41 |
Where Missouri sits
The same service costs 2.8 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· 32nd of 51
$41.69
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.