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 $5.62 Median $10.72 Typical High $25.70 | Facility | None | $5.62 | $10.72 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $5.01 Median $10.00 Typical High $25.70 | Professional | None | $5.01 | $10.00 | $25.70 |
Ambetter Setting Professional Modifier None Typical Low $16.98 Median $21.38 Typical High $27.54 | Professional | None | $16.98 | $21.38 | $27.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.01 Median $16.98 Typical High $24.55 | Professional | None | $5.01 | $16.98 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $20.42 Typical High $33.88 | Professional | None | $18.20 | $20.42 | $33.88 |
Medica Setting Facility Modifier None Typical Low $15.49 Median $42.66 Typical High $95.50 | Facility | None | $15.49 | $42.66 | $95.50 |
Medica Setting Professional Modifier None Typical Low $13.18 Median $22.91 Typical High $35.48 | Professional | None | $13.18 | $22.91 | $35.48 |
United Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $239.88 | Facility | None | $229.09 | $229.09 | $239.88 |
United Setting Professional Modifier None Typical Low $13.18 Median $22.91 Typical High $36.31 | Professional | None | $13.18 | $22.91 | $36.31 |
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 $2.51 Median $5.01 Typical High $5.01 | Professional | 52 · Reduced service | $2.51 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.00 Median $2.00 Typical High $2.00 | Professional | 53 · Discontinued | $1.00 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.76 Median $1.51 Typical High $1.51 | Professional | 55 · Aftercare only | $0.76 | $1.51 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.50 Median $1.00 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.50 | $1.00 | $1.00 |
Where Missouri sits
The same service costs 5.4 times more in Vermont than in Kansas. 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· 48th of 51
$18.62
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.