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 $181.97 Median $186.21 Typical High $186.21 | Facility | None | $181.97 | $186.21 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $186.21 Typical High $218.78 | Professional | None | $181.97 | $186.21 | $218.78 |
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 $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 $181.97 Median $446.68 Typical High $812.83 | Facility | None | $181.97 | $446.68 | $812.83 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $812.83 | Professional | None | $181.97 | $181.97 | $812.83 |
United Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $147.91 | Professional | None | $114.82 | $125.89 | $147.91 |
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 $91.20 Median $93.33 Typical High $109.65 | Professional | 52 · Reduced service | $91.20 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $37.15 Typical High $43.65 | Professional | 53 · Discontinued | $36.31 | $37.15 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $141.25 Typical High $162.18 | Professional | 54 · Surgery only | $138.04 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $28.18 Typical High $33.11 | Professional | 55 · Aftercare only | $27.54 | $28.18 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.62 Typical High $21.88 | Professional | 56 · Pre-op care only | $18.20 | $18.62 | $21.88 |
Where Missouri sits
The same service costs 3.6 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· 45th 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.