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 $457.09 Median $478.63 Typical High $478.63 | Facility | None | $457.09 | $478.63 | $478.63 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $478.63 Typical High $549.54 | Professional | None | $457.09 | $478.63 | $549.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $138.04 | Professional | None | $97.72 | $109.65 | $138.04 |
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 $165.96 Median $707.95 Typical High $3,162.28 | Facility | None | $165.96 | $707.95 | $3,162.28 |
Medica Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $3,630.78 | Professional | None | $331.13 | $331.13 | $3,630.78 |
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 $229.09 Median $239.88 Typical High $275.42 | Professional | 52 · Reduced service | $229.09 | $239.88 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $95.50 Typical High $109.65 | Professional | 53 · Discontinued | $93.33 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $70.79 Typical High $83.18 | Professional | 55 · Aftercare only | $69.18 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $47.86 Typical High $54.95 | Professional | 56 · Pre-op care only | $45.71 | $47.86 | $54.95 |
Where Missouri sits
The same service costs 12.0 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· 42nd 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.