How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $190.55 | Professional | None | $134.90 | $181.97 | $190.55 |
BCBS Kansas City Setting Professional Modifier None Typical Low $218.78 Median $229.09 Typical High $309.03 | Professional | None | $218.78 | $229.09 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $251.19 Typical High $288.40 | Facility | None | $173.78 | $251.19 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Medica Setting Facility Modifier None Typical Low $144.54 Median $181.97 Typical High $676.08 | Facility | None | $144.54 | $181.97 | $676.08 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $181.97 Typical High $691.83 | Professional | None | $177.83 | $181.97 | $691.83 |
United Setting Professional Modifier None Typical Low $162.18 Median $181.97 Typical High $204.17 | Professional | None | $162.18 | $181.97 | $204.17 |
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 $72.44 Median $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | 55 · Aftercare only | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $14.45 |
Where Missouri sits
The same service costs 2.2 times more in North Carolina than in Michigan. 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· 6th of 51
$182
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.