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 $0.54 Median $0.63 Typical High $0.63 | Facility | None | $0.54 | $0.63 | $0.63 |
Aetna Setting Professional Modifier None Typical Low $0.46 Median $0.54 Typical High $0.63 | Professional | None | $0.46 | $0.54 | $0.63 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.23 Median $0.27 Typical High $0.32 | Professional | 52 · Reduced service | $0.23 | $0.27 | $0.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.09 Median $0.11 Typical High $0.13 | Professional | 53 · Discontinued | $0.09 | $0.11 | $0.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.07 Median $0.08 Typical High $0.09 | Professional | 55 · Aftercare only | $0.07 | $0.08 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.06 |
Aetna Setting Professional Modifier RR · Rental Typical Low $0.05 Median $0.05 Typical High $0.06 | Professional | RR · Rental | $0.05 | $0.05 | $0.06 |
BCBS Mississippi Setting Facility Modifier None Typical Low $0.65 Median $0.65 Typical High $0.71 | Facility | None | $0.65 | $0.65 | $0.71 |
BCBS Mississippi Setting Professional Modifier None Typical Low $0.49 Median $0.49 Typical High $0.49 | Professional | None | $0.49 | $0.49 | $0.49 |
Cigna Setting Facility Modifier None Typical Low $0.38 Median $0.38 Typical High $0.38 | Facility | None | $0.38 | $0.38 | $0.38 |
Cigna Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | None | $0.31 | $0.31 | $0.31 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $1,995.26 Typical High $1,995.26 | Professional | None | $30.20 | $1,995.26 | $1,995.26 |
United Setting Professional Modifier None Typical Low $0.17 Median $0.28 Typical High $0.38 | Professional | None | $0.17 | $0.28 | $0.38 |
1 more rate 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier SC · Medically necessary Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | SC · Medically necessary | $43.65 | $43.65 | $43.65 |
Where Mississippi 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.
Mississippi· 39th of 51
$0.31
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.