How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $0.15 Median $0.15 Typical High $0.15 | Facility | None | $0.15 | $0.15 | $0.15 |
Aetna Setting Professional Modifier None Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | None | $0.15 | $0.15 | $0.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.05 Median $0.05 Typical High $0.06 | Professional | None | $0.05 | $0.05 | $0.06 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.04 Median $0.11 Typical High $0.14 | Professional | UE · Used equipment | $0.04 | $0.11 | $0.14 |
BCBS Kansas City Setting Professional Modifier None Typical Low $0.18 Median $0.19 Typical High $0.26 | Professional | None | $0.18 | $0.19 | $0.26 |
Cigna Setting Professional Modifier None Typical Low $0.30 Median $0.30 Typical High $0.30 | Professional | None | $0.30 | $0.30 | $0.30 |
Medica Setting Facility Modifier None Typical Low $0.15 Median $79.43 Typical High $100.00 | Facility | None | $0.15 | $79.43 | $100.00 |
Medica Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | None | $1.38 | $1.38 | $1.38 |
United Setting Professional Modifier None Typical Low $0.17 Median $0.17 Typical High $0.17 | Professional | None | $0.17 | $0.17 | $0.17 |
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 $0.08 Median $0.08 Typical High $0.08 | Professional | 52 · Reduced service | $0.08 | $0.08 | $0.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 53 · Discontinued | $0.03 | $0.03 | $0.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.02 |
Where Missouri sits
The same service costs 1318.3 times more in Montana than in Missouri. 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· 51st of 51
$0.06
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.