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 $70.79 Median $72.44 Typical High $72.44 | Facility | None | $70.79 | $72.44 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $72.44 Typical High $85.11 | Professional | None | $70.79 | $72.44 | $85.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $181.97 | Professional | None | $97.72 | $109.65 | $181.97 |
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 $72.44 Median $302.00 Typical High $346.74 | Facility | None | $72.44 | $302.00 | $346.74 |
Medica Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $457.09 | Professional | None | $70.79 | $70.79 | $457.09 |
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 $35.48 Median $36.31 Typical High $42.66 | Professional | 52 · Reduced service | $35.48 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.45 Typical High $16.98 | Professional | 53 · Discontinued | $14.13 | $14.45 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $10.96 Typical High $12.59 | Professional | 55 · Aftercare only | $10.72 | $10.96 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.24 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.08 | $7.24 | $8.51 |
Where Missouri sits
The same service costs 3.6 times more in Wyoming than in Indiana. 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
$115
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.