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 $7.76 Median $18.20 Typical High $18.20 | Facility | None | $7.76 | $18.20 | $18.20 |
Aetna Setting Professional Modifier None Typical Low $7.76 Median $10.96 Typical High $18.20 | Professional | None | $7.76 | $10.96 | $18.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.41 Median $10.23 Typical High $15.49 | Professional | None | $7.41 | $10.23 | $15.49 |
BCBS Kansas City Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $18.20 | Professional | None | $10.96 | $10.96 | $18.20 |
Cigna Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | None | $7.59 | $7.59 | $7.59 |
Medica Setting Facility Modifier None Typical Low $9.55 Median $36.31 Typical High $89.13 | Facility | None | $9.55 | $36.31 | $89.13 |
Medica Setting Professional Modifier None Typical Low $6.31 Median $8.91 Typical High $151.36 | Professional | None | $6.31 | $8.91 | $151.36 |
United Setting Professional Modifier None Typical Low $6.03 Median $8.91 Typical High $14.79 | Professional | None | $6.03 | $8.91 | $14.79 |
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 $3.89 Median $5.50 Typical High $8.91 | Professional | 52 · Reduced service | $3.89 | $5.50 | $8.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.55 Median $2.19 Typical High $3.63 | Professional | 53 · Discontinued | $1.55 | $2.19 | $3.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $5.75 Median $8.32 Typical High $13.49 | Professional | 54 · Surgery only | $5.75 | $8.32 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.15 Median $1.66 Typical High $2.69 | Professional | 55 · Aftercare only | $1.15 | $1.66 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.78 Median $1.10 Typical High $1.82 | Professional | 56 · Pre-op care only | $0.78 | $1.10 | $1.82 |
Where Missouri sits
The same service costs 2.7 times more in Idaho 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· 34th of 51
$10.23
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.