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 $17.78 Median $41.69 Typical High $41.69 | Facility | None | $17.78 | $41.69 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $25.70 Typical High $41.69 | Professional | None | $17.78 | $25.70 | $41.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.38 Median $23.99 Typical High $33.88 | Professional | None | $17.38 | $23.99 | $33.88 |
BCBS Kansas City Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $42.66 | Professional | None | $25.70 | $25.70 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Medica Setting Facility Modifier None Typical Low $22.39 Median $85.11 Typical High $194.98 | Facility | None | $22.39 | $85.11 | $194.98 |
Medica Setting Professional Modifier None Typical Low $14.79 Median $20.89 Typical High $269.15 | Professional | None | $14.79 | $20.89 | $269.15 |
United Setting Professional Modifier None Typical Low $13.80 Median $20.89 Typical High $33.88 | Professional | None | $13.80 | $20.89 | $33.88 |
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 $8.91 Median $12.88 Typical High $20.89 | Professional | 52 · Reduced service | $8.91 | $12.88 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $5.13 Typical High $8.32 | Professional | 53 · Discontinued | $3.63 | $5.13 | $8.32 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $13.49 Median $19.05 Typical High $31.62 | Professional | 54 · Surgery only | $13.49 | $19.05 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $3.80 Typical High $6.31 | Professional | 55 · Aftercare only | $2.69 | $3.80 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $2.57 Typical High $4.17 | Professional | 56 · Pre-op care only | $1.78 | $2.57 | $4.17 |
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
$23.99
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.