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 $660.69 Median $676.08 Typical High $676.08 | Facility | None | $660.69 | $676.08 | $676.08 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $676.08 Typical High $794.33 | Professional | None | $660.69 | $676.08 | $794.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $1,412.54 | Professional | None | $97.72 | $109.65 | $1,412.54 |
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 $741.31 Median $1,737.80 Typical High $5,128.61 | Facility | None | $741.31 | $1,737.80 | $5,128.61 |
Medica Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $5,754.40 | Professional | None | $724.44 | $724.44 | $5,754.40 |
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 $331.13 Median $338.84 Typical High $389.05 | Professional | 52 · Reduced service | $331.13 | $338.84 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $134.90 Typical High $158.49 | Professional | 53 · Discontinued | $131.83 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $102.33 Typical High $117.49 | Professional | 55 · Aftercare only | $97.72 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $67.61 Typical High $79.43 | Professional | 56 · Pre-op care only | $66.07 | $67.61 | $79.43 |
Where Missouri sits
The same service costs 12.6 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· 47th 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.