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 $7.24 Median $16.98 Typical High $16.98 | Facility | None | $7.24 | $16.98 | $16.98 |
Aetna Setting Professional Modifier None Typical Low $7.24 Median $10.23 Typical High $16.98 | Professional | None | $7.24 | $10.23 | $16.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.92 Median $9.55 Typical High $13.80 | Professional | None | $6.92 | $9.55 | $13.80 |
BCBS Kansas City Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $16.98 | Professional | None | $10.23 | $10.23 | $16.98 |
Cigna Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
Medica Setting Facility Modifier None Typical Low $8.91 Median $33.88 Typical High $89.13 | Facility | None | $8.91 | $33.88 | $89.13 |
Medica Setting Professional Modifier None Typical Low $5.89 Median $8.32 Typical High $125.89 | Professional | None | $5.89 | $8.32 | $125.89 |
United Setting Professional Modifier None Typical Low $5.62 Median $8.32 Typical High $13.80 | Professional | None | $5.62 | $8.32 | $13.80 |
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 $3.63 Median $5.13 Typical High $8.32 | Professional | 52 · Reduced service | $3.63 | $5.13 | $8.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.45 Median $2.04 Typical High $3.39 | Professional | 53 · Discontinued | $1.45 | $2.04 | $3.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $5.37 Median $7.76 Typical High $12.59 | Professional | 54 · Surgery only | $5.37 | $7.76 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.07 Median $1.55 Typical High $2.51 | Professional | 55 · Aftercare only | $1.07 | $1.55 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.72 Median $1.02 Typical High $1.70 | Professional | 56 · Pre-op care only | $0.72 | $1.02 | $1.70 |
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
$9.55
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.