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 $10.72 Median $25.12 Typical High $25.12 | Facility | None | $10.72 | $25.12 | $25.12 |
Aetna Setting Professional Modifier None Typical Low $10.72 Median $15.14 Typical High $25.12 | Professional | None | $10.72 | $15.14 | $25.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.23 Median $14.13 Typical High $21.88 | Professional | None | $10.23 | $14.13 | $21.88 |
BCBS Kansas City Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $25.70 | Professional | None | $15.14 | $15.14 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | None | $10.47 | $10.47 | $10.47 |
Medica Setting Facility Modifier None Typical Low $13.18 Median $51.29 Typical High $117.49 | Facility | None | $13.18 | $51.29 | $117.49 |
Medica Setting Professional Modifier None Typical Low $8.91 Median $12.59 Typical High $199.53 | Professional | None | $8.91 | $12.59 | $199.53 |
United Setting Professional Modifier None Typical Low $8.32 Median $12.30 Typical High $20.42 | Professional | None | $8.32 | $12.30 | $20.42 |
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 $5.37 Median $7.59 Typical High $12.59 | Professional | 52 · Reduced service | $5.37 | $7.59 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.14 Median $3.02 Typical High $5.01 | Professional | 53 · Discontinued | $2.14 | $3.02 | $5.01 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.94 Median $11.48 Typical High $18.62 | Professional | 54 · Surgery only | $7.94 | $11.48 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.62 Median $2.29 Typical High $3.72 | Professional | 55 · Aftercare only | $1.62 | $2.29 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.51 Typical High $2.51 | Professional | 56 · Pre-op care only | $1.07 | $1.51 | $2.51 |
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
$14.13
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.