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 $107.15 Median $109.65 Typical High $562.34 | Facility | None | $107.15 | $109.65 | $562.34 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $109.65 Typical High $128.82 | Professional | None | $107.15 | $109.65 | $128.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $162.18 | Professional | None | $97.72 | $109.65 | $162.18 |
BCBS Kansas City Setting Professional Modifier None Typical Low $120.23 Median $138.04 Typical High $181.97 | Professional | None | $120.23 | $138.04 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $190.55 Typical High $281.84 | Facility | None | $125.89 | $190.55 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Medica Setting Facility Modifier None Typical Low $95.50 Median $562.34 Typical High $602.56 | Facility | None | $95.50 | $562.34 | $602.56 |
Medica Setting Professional Modifier None Typical Low $79.43 Median $89.13 Typical High $1,445.44 | Professional | None | $79.43 | $89.13 | $1,445.44 |
United Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $147.91 | Professional | None | $114.82 | $125.89 | $147.91 |
4 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 $53.70 Median $54.95 Typical High $64.57 | Professional | 52 · Reduced service | $53.70 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.88 Typical High $25.70 | Professional | 53 · Discontinued | $21.38 | $21.88 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.60 Typical High $19.05 | Professional | 55 · Aftercare only | $15.85 | $16.60 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.96 Typical High $12.88 | Professional | 56 · Pre-op care only | $10.72 | $10.96 | $12.88 |
Where Missouri sits
The same service costs 6.0 times more in Wyoming than in Montana. 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
$120
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.