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 $549.54 Median $575.44 Typical High $575.44 | Facility | None | $549.54 | $575.44 | $575.44 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $575.44 Typical High $660.69 | Professional | None | $549.54 | $575.44 | $660.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $575.44 | Professional | None | $97.72 | $109.65 | $575.44 |
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 $199.53 Median $1,071.52 Typical High $2,511.89 | Facility | None | $199.53 | $1,071.52 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $4,786.30 | Professional | None | $194.98 | $194.98 | $4,786.30 |
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 $275.42 Median $288.40 Typical High $331.13 | Professional | 52 · Reduced service | $275.42 | $288.40 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $114.82 Typical High $131.83 | Professional | 53 · Discontinued | $109.65 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $85.11 Typical High $100.00 | Professional | 55 · Aftercare only | $83.18 | $85.11 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $57.54 Typical High $66.07 | Professional | 56 · Pre-op care only | $54.95 | $57.54 | $66.07 |
Where Missouri sits
The same service costs 9.1 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· 49th 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.