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 $141.25 Median $151.36 Typical High $229.09 | Facility | None | $141.25 | $151.36 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $154.88 Typical High $181.97 | Professional | None | $151.36 | $154.88 | $181.97 |
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 $177.83 | Professional | None | $120.23 | $138.04 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $223.87 Typical High $371.54 | Facility | None | $144.54 | $223.87 | $371.54 |
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 $151.36 Median $338.84 Typical High $691.83 | Facility | None | $151.36 | $338.84 | $691.83 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $691.83 | Professional | None | $151.36 | $151.36 | $691.83 |
United Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $147.91 | Professional | None | $114.82 | $125.89 | $147.91 |
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 $75.86 Median $75.86 Typical High $91.20 | Professional | 52 · Reduced service | $75.86 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $36.31 | Professional | 53 · Discontinued | $30.20 | $30.20 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $26.92 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $18.20 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $18.20 |
Where Missouri sits
The same service costs 2.9 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· 41st 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.