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 $14.45 Median $33.88 Typical High $33.88 | Facility | None | $14.45 | $33.88 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $14.45 Median $20.42 Typical High $33.88 | Professional | None | $14.45 | $20.42 | $33.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.80 Median $19.05 Typical High $27.54 | Professional | None | $13.80 | $19.05 | $27.54 |
BCBS Kansas City Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $34.67 | Professional | None | $20.42 | $20.42 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
Medica Setting Facility Modifier None Typical Low $17.78 Median $67.61 Typical High $158.49 | Facility | None | $17.78 | $67.61 | $158.49 |
Medica Setting Professional Modifier None Typical Low $12.02 Median $16.98 Typical High $257.04 | Professional | None | $12.02 | $16.98 | $257.04 |
United Setting Professional Modifier None Typical Low $11.22 Median $16.60 Typical High $27.54 | Professional | None | $11.22 | $16.60 | $27.54 |
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 $7.24 Median $10.23 Typical High $16.98 | Professional | 52 · Reduced service | $7.24 | $10.23 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.88 Median $4.07 Typical High $6.76 | Professional | 53 · Discontinued | $2.88 | $4.07 | $6.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.72 Median $15.49 Typical High $25.12 | Professional | 54 · Surgery only | $10.72 | $15.49 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $3.09 Typical High $5.01 | Professional | 55 · Aftercare only | $2.14 | $3.09 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $2.04 Typical High $3.39 | Professional | 56 · Pre-op care only | $1.45 | $2.04 | $3.39 |
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· 34th 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.