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 $147.91 Median $208.93 Typical High $575.44 | Facility | None | $147.91 | $208.93 | $575.44 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $154.88 Typical High $204.17 | Professional | None | $147.91 | $154.88 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $144.54 Median $199.53 Typical High $478.63 | Facility | None | $144.54 | $199.53 | $478.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $169.82 Typical High $416.87 | Professional | None | $138.04 | $169.82 | $416.87 |
BCBS Kansas City Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $707.95 | Professional | None | $162.18 | $162.18 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $354.81 Typical High $416.87 | Facility | None | $186.21 | $354.81 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $389.05 Typical High $1,445.44 | Facility | None | $134.90 | $389.05 | $1,445.44 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $1,348.96 Typical High $1,348.96 | Professional | None | $134.90 | $1,348.96 | $1,348.96 |
United Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
United Setting Professional Modifier None Typical Low $123.03 Median $144.54 Typical High $162.18 | Professional | None | $123.03 | $144.54 | $162.18 |
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 $74.13 Median $77.62 Typical High $89.13 | Professional | 52 · Reduced service | $74.13 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $30.90 Typical High $35.48 | Professional | 53 · Discontinued | $29.51 | $30.90 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.91 Typical High $26.92 | Professional | 55 · Aftercare only | $22.39 | $22.91 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $15.49 Typical High $17.78 | Professional | 56 · Pre-op care only | $14.79 | $15.49 | $17.78 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $134.90 Median $147.91 Typical High $162.18 | Professional | JZ · No drug discarded | $134.90 | $147.91 | $162.18 |
Where Missouri sits
The same service costs 2.4 times more in Wyoming 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· 11th of 51
$151
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.