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 $138.04 Median $144.54 Typical High $281.84 | Facility | None | $138.04 | $144.54 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $144.54 Typical High $165.96 | Professional | None | $138.04 | $144.54 | $165.96 |
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 $144.54 Median $269.15 Typical High $616.60 | Facility | None | $144.54 | $269.15 | $616.60 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $1,445.44 | Professional | None | $134.90 | $134.90 | $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 $69.18 Median $70.79 Typical High $83.18 | Professional | 52 · Reduced service | $69.18 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $28.84 Typical High $33.11 | Professional | 53 · Discontinued | $27.54 | $28.84 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $21.38 Typical High $25.12 | Professional | 55 · Aftercare only | $20.89 | $21.38 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $14.45 Typical High $16.60 | Professional | 56 · Pre-op care only | $13.80 | $14.45 | $16.60 |
Where Missouri sits
The same service costs 2.2 times more in Alaska than in North Carolina. 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· 41st of 51
$126
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.