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 $19.95 Median $20.42 Typical High $20.42 | Facility | None | $19.95 | $20.42 | $20.42 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $20.42 Typical High $23.99 | Professional | None | $19.95 | $20.42 | $23.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $21.38 Median $109.65 Typical High $134.90 | Professional | None | $21.38 | $109.65 | $134.90 |
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 $144.54 Median $223.87 Typical High $302.00 | Facility | None | $144.54 | $223.87 | $302.00 |
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 $19.50 Median $24.55 Typical High $91.20 | Facility | None | $19.50 | $24.55 | $91.20 |
Medica Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $91.20 | Professional | None | $20.89 | $20.89 | $91.20 |
United Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $144.54 | Professional | None | $114.82 | $125.89 | $144.54 |
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 $10.00 Median $10.23 Typical High $12.02 | Professional | 52 · Reduced service | $10.00 | $10.23 | $12.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $4.07 Typical High $4.79 | Professional | 53 · Discontinued | $3.98 | $4.07 | $4.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.09 Typical High $3.63 | Professional | 55 · Aftercare only | $3.02 | $3.09 | $3.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $2.04 Typical High $2.40 | Professional | 56 · Pre-op care only | $2.00 | $2.04 | $2.40 |
Where Missouri sits
The same service costs 6.3 times more in Massachusetts than in Indiana. 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· 22nd 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.