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 $102.33 Median $104.71 Typical High $269.15 | Facility | None | $102.33 | $104.71 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $104.71 Typical High $123.03 | Professional | None | $102.33 | $104.71 | $123.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $138.04 | Professional | None | $97.72 | $109.65 | $138.04 |
BCBS Kansas City Setting Professional Modifier None Typical Low $120.23 Median $138.04 Typical High $177.83 | Professional | None | $120.23 | $138.04 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $190.55 Typical High $269.15 | Facility | None | $125.89 | $190.55 | $269.15 |
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 $104.71 Median $229.09 Typical High $512.86 | Facility | None | $104.71 | $229.09 | $512.86 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $512.86 | Professional | None | $100.00 | $100.00 | $512.86 |
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 $51.29 Median $52.48 Typical High $61.66 | Professional | 52 · Reduced service | $51.29 | $52.48 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.89 Typical High $24.55 | Professional | 53 · Discontinued | $20.42 | $20.89 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.85 Typical High $18.20 | Professional | 55 · Aftercare only | $15.14 | $15.85 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.47 Typical High $12.30 | Professional | 56 · Pre-op care only | $10.23 | $10.47 | $12.30 |
Where Missouri sits
The same service costs 2.4 times more in Wyoming 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· 43rd of 51
$117
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.