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 $21.88 Median $28.84 Typical High $51.29 | Facility | None | $21.88 | $28.84 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $38.02 Typical High $66.07 | Professional | None | $21.88 | $38.02 | $66.07 |
Ambetter Setting Professional Modifier None Typical Low $34.67 Median $39.81 Typical High $81.28 | Professional | None | $34.67 | $39.81 | $81.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $21.38 Median $29.51 Typical High $41.69 | Professional | None | $21.38 | $29.51 | $41.69 |
BCBS Kansas City Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $52.48 | Professional | None | $31.62 | $31.62 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Medica Setting Facility Modifier None Typical Low $27.54 Median $104.71 Typical High $316.23 | Facility | None | $27.54 | $104.71 | $316.23 |
Medica Setting Professional Modifier None Typical Low $18.20 Median $25.70 Typical High $724.44 | Professional | None | $18.20 | $25.70 | $724.44 |
United Setting Professional Modifier None Typical Low $16.98 Median $25.70 Typical High $41.69 | Professional | None | $16.98 | $25.70 | $41.69 |
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 $10.96 Median $15.85 Typical High $25.70 | Professional | 52 · Reduced service | $10.96 | $15.85 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $6.31 Typical High $10.23 | Professional | 53 · Discontinued | $4.37 | $6.31 | $10.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $16.60 Median $23.44 Typical High $38.90 | Professional | 54 · Surgery only | $16.60 | $23.44 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $4.68 Typical High $7.76 | Professional | 55 · Aftercare only | $3.31 | $4.68 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $3.16 Typical High $5.13 | Professional | 56 · Pre-op care only | $2.19 | $3.16 | $5.13 |
Where Missouri sits
The same service costs 2.6 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· 38th of 51
$29.51
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.