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 $0.27 Median $0.62 Typical High $26.30 | Facility | None | $0.27 | $0.62 | $26.30 |
Aetna Setting Professional Modifier None Typical Low $0.27 Median $0.38 Typical High $0.62 | Professional | None | $0.27 | $0.38 | $0.62 |
Ambetter Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.41 Median $0.55 Typical High $1.26 | Professional | None | $0.41 | $0.55 | $1.26 |
BCBS Kansas City Setting Professional Modifier None Typical Low $0.38 Median $0.38 Typical High $0.63 | Professional | None | $0.38 | $0.38 | $0.63 |
Cigna Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | None | $0.31 | $0.31 | $0.31 |
Medica Setting Facility Modifier None Typical Low $0.34 Median $1.26 Typical High $79.43 | Facility | None | $0.34 | $1.26 | $79.43 |
Medica Setting Professional Modifier None Typical Low $0.22 Median $0.31 Typical High $4.27 | Professional | None | $0.22 | $0.31 | $4.27 |
United Setting Professional Modifier None Typical Low $0.21 Median $0.30 Typical High $0.47 | Professional | None | $0.21 | $0.30 | $0.47 |
6 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 $0.14 Median $0.19 Typical High $0.31 | Professional | 52 · Reduced service | $0.14 | $0.19 | $0.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.05 Median $0.08 Typical High $0.12 | Professional | 53 · Discontinued | $0.05 | $0.08 | $0.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.04 Median $0.06 Typical High $0.09 | Professional | 55 · Aftercare only | $0.04 | $0.06 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.04 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.03 | $0.04 | $0.06 |
Aetna Setting Professional Modifier RR · Rental Typical Low $0.03 Median $0.04 Typical High $0.06 | Professional | RR · Rental | $0.03 | $0.04 | $0.06 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.25 Median $0.25 Typical High $0.35 | Professional | UE · Used equipment | $0.25 | $0.25 | $0.35 |
Where Missouri sits
The same service costs 4.6 times more in Hawaii than in Rhode Island. 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· 13th of 51
$0.52
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.