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 $489.78 Median $501.19 Typical High $501.19 | Facility | None | $489.78 | $501.19 | $501.19 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $501.19 Typical High $588.84 | Professional | None | $489.78 | $501.19 | $588.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $309.03 | Professional | None | $97.72 | $109.65 | $309.03 |
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 $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 $501.19 Median $977.24 Typical High $1,905.46 | Facility | None | $501.19 | $977.24 | $1,905.46 |
Medica Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $2,398.83 | Professional | None | $489.78 | $489.78 | $2,398.83 |
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 $245.47 Median $251.19 Typical High $295.12 | Professional | 52 · Reduced service | $245.47 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $100.00 Typical High $117.49 | Professional | 53 · Discontinued | $97.72 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $75.86 Typical High $87.10 | Professional | 55 · Aftercare only | $72.44 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $50.12 Typical High $58.88 | Professional | 56 · Pre-op care only | $48.98 | $50.12 | $58.88 |
Where Missouri sits
The same service costs 7.1 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· 39th 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.