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 $87.10 Median $91.20 Typical High $91.20 | Facility | None | $87.10 | $91.20 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $91.20 Typical High $104.71 | Professional | None | $87.10 | $91.20 | $104.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $173.78 | Professional | None | $97.72 | $109.65 | $173.78 |
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 $81.28 Median $151.36 Typical High $524.81 | Facility | None | $81.28 | $151.36 | $524.81 |
Medica Setting Professional Modifier None Typical Low $79.43 Median $81.28 Typical High $562.34 | Professional | None | $79.43 | $81.28 | $562.34 |
United Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $144.54 | Professional | None | $114.82 | $125.89 | $144.54 |
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 $43.65 Median $45.71 Typical High $52.48 | Professional | 52 · Reduced service | $43.65 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $18.20 Typical High $20.89 | Professional | 53 · Discontinued | $17.78 | $18.20 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.49 Typical High $15.85 | Professional | 55 · Aftercare only | $13.18 | $13.49 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.12 Typical High $10.47 | Professional | 56 · Pre-op care only | $8.71 | $9.12 | $10.47 |
Where Missouri sits
The same service costs 1.9 times more in Alaska than in New York. 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· 36th 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.