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 $20.42 Median $47.86 Typical High $47.86 | Facility | None | $20.42 | $47.86 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $28.84 Typical High $47.86 | Professional | None | $20.42 | $28.84 | $47.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.50 Median $26.92 Typical High $38.90 | Professional | None | $19.50 | $26.92 | $38.90 |
BCBS Kansas City Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $48.98 | Professional | None | $28.84 | $28.84 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
Medica Setting Facility Modifier None Typical Low $25.12 Median $95.50 Typical High $223.87 | Facility | None | $25.12 | $95.50 | $223.87 |
Medica Setting Professional Modifier None Typical Low $16.98 Median $23.44 Typical High $316.23 | Professional | None | $16.98 | $23.44 | $316.23 |
United Setting Professional Modifier None Typical Low $15.85 Median $23.44 Typical High $38.90 | Professional | None | $15.85 | $23.44 | $38.90 |
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 $10.23 Median $14.45 Typical High $23.99 | Professional | 52 · Reduced service | $10.23 | $14.45 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $5.75 Typical High $9.55 | Professional | 53 · Discontinued | $4.07 | $5.75 | $9.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.14 Median $21.88 Typical High $35.48 | Professional | 54 · Surgery only | $15.14 | $21.88 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $4.37 Typical High $7.08 | Professional | 55 · Aftercare only | $3.02 | $4.37 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.88 Typical High $4.79 | Professional | 56 · Pre-op care only | $2.04 | $2.88 | $4.79 |
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· 33rd of 51
$26.92
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.