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 $24.55 Median $31.62 Typical High $117.49 | Facility | None | $24.55 | $31.62 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $25.12 Typical High $35.48 | Professional | None | $24.55 | $25.12 | $35.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $25.12 Median $33.11 Typical High $83.18 | Facility | None | $25.12 | $33.11 | $83.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $24.55 Median $29.51 Typical High $83.18 | Professional | None | $24.55 | $29.51 | $83.18 |
BCBS Kansas City Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $141.25 | Professional | None | $26.92 | $26.92 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $30.90 Median $46.77 Typical High $63.10 | Facility | None | $30.90 | $46.77 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Medica Setting Facility Modifier None Typical Low $28.18 Median $43.65 Typical High $93.33 | Facility | None | $28.18 | $43.65 | $93.33 |
Medica Setting Professional Modifier None Typical Low $28.84 Median $125.89 Typical High $125.89 | Professional | None | $28.84 | $125.89 | $125.89 |
United Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
United Setting Professional Modifier None Typical Low $21.38 Median $25.12 Typical High $28.18 | Professional | None | $21.38 | $25.12 | $28.18 |
5 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 $12.30 Median $12.59 Typical High $16.60 | Professional | 52 · Reduced service | $12.30 | $12.59 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $5.01 Typical High $6.61 | Professional | 53 · Discontinued | $4.90 | $5.01 | $6.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.80 Typical High $5.01 | Professional | 55 · Aftercare only | $3.72 | $3.80 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.51 Typical High $3.31 | Professional | 56 · Pre-op care only | $2.45 | $2.51 | $3.31 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $23.99 Median $24.55 Typical High $28.18 | Professional | JZ · No drug discarded | $23.99 | $24.55 | $28.18 |
Where Missouri sits
The same service costs 2.8 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· 10th of 51
$26.92
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.