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 $10.96 Median $25.70 Typical High $25.70 | Facility | None | $10.96 | $25.70 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $10.96 Median $17.38 Typical High $25.70 | Professional | None | $10.96 | $17.38 | $25.70 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.72 Median $14.79 Typical High $20.89 | Professional | None | $10.72 | $14.79 | $20.89 |
BCBS Kansas City Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $26.30 | Professional | None | $15.85 | $15.85 | $26.30 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
Medica Setting Facility Modifier None Typical Low $13.80 Median $52.48 Typical High $158.49 | Facility | None | $13.80 | $52.48 | $158.49 |
Medica Setting Professional Modifier None Typical Low $9.12 Median $12.88 Typical High $363.08 | Professional | None | $9.12 | $12.88 | $363.08 |
United Setting Professional Modifier None Typical Low $8.51 Median $12.88 Typical High $20.89 | Professional | None | $8.51 | $12.88 | $20.89 |
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 $5.50 Median $7.76 Typical High $12.88 | Professional | 52 · Reduced service | $5.50 | $7.76 | $12.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.19 Median $3.16 Typical High $5.13 | Professional | 53 · Discontinued | $2.19 | $3.16 | $5.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.32 Median $11.75 Typical High $19.50 | Professional | 54 · Surgery only | $8.32 | $11.75 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.66 Median $2.34 Typical High $3.89 | Professional | 55 · Aftercare only | $1.66 | $2.34 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.10 Median $1.58 Typical High $2.57 | Professional | 56 · Pre-op care only | $1.10 | $1.58 | $2.57 |
Where Missouri sits
The same service costs 3.5 times more in Rhode Island 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· 39th of 51
$14.79
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.