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 $67.61 Median $69.18 Typical High $69.18 | Facility | None | $67.61 | $69.18 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $69.18 Typical High $81.28 | Professional | None | $67.61 | $69.18 | $81.28 |
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 $181.97 | Professional | None | $120.23 | $138.04 | $181.97 |
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 $67.61 Median $204.17 Typical High $776.25 | Facility | None | $67.61 | $204.17 | $776.25 |
Medica Setting Professional Modifier None Typical Low $63.10 Median $66.07 Typical High $776.25 | Professional | None | $63.10 | $66.07 | $776.25 |
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 $33.88 Median $34.67 Typical High $40.74 | Professional | 52 · Reduced service | $33.88 | $34.67 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.80 Typical High $16.22 | Professional | 53 · Discontinued | $13.49 | $13.80 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.47 Typical High $12.02 | Professional | 55 · Aftercare only | $10.00 | $10.47 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.92 Typical High $8.13 | Professional | 56 · Pre-op care only | $6.76 | $6.92 | $8.13 |
Where Missouri sits
The same service costs 2.6 times more in Wyoming than in Washington, DC. 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· 36th of 51
$110
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.