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 $89.13 Median $91.20 Typical High $91.20 | Facility | None | $89.13 | $91.20 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $91.20 Typical High $107.15 | Professional | None | $89.13 | $91.20 | $107.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $173.78 | Professional | None | $97.72 | $109.65 | $173.78 |
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 $79.43 Median $223.87 Typical High $389.05 | Facility | None | $79.43 | $223.87 | $389.05 |
Medica Setting Professional Modifier None Typical Low $91.20 Median $93.33 Typical High $436.52 | Professional | None | $91.20 | $93.33 | $436.52 |
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 $44.67 Median $45.71 Typical High $53.70 | Professional | 52 · Reduced service | $44.67 | $45.71 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $18.62 Typical High $21.38 | Professional | 53 · Discontinued | $17.78 | $18.62 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.80 Typical High $16.22 | Professional | 55 · Aftercare only | $13.49 | $13.80 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $9.12 Typical High $10.72 | Professional | 56 · Pre-op care only | $8.91 | $9.12 | $10.72 |
Where Missouri sits
The same service costs 2.1 times more in Wyoming than in Kentucky. 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· 37th 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.