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 $0.28 Median $0.69 Typical High $0.69 | Facility | None | $0.28 | $0.69 | $0.69 |
Aetna Setting Professional Modifier None Typical Low $0.28 Median $0.42 Typical High $0.69 | Professional | None | $0.28 | $0.42 | $0.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.68 Median $1.48 Typical High $2.14 | Professional | None | $0.68 | $1.48 | $2.14 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.56 Median $1.58 Typical High $1.58 | Professional | UE · Used equipment | $0.56 | $1.58 | $1.58 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1.41 Median $1.48 Typical High $1.78 | Professional | None | $1.41 | $1.48 | $1.78 |
Cigna Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | None | $1.82 | $1.82 | $1.82 |
Medica Setting Facility Modifier None Typical Low $0.37 Median $1.29 Typical High $89.13 | Facility | None | $0.37 | $1.29 | $89.13 |
Medica Setting Professional Modifier None Typical Low $0.36 Median $0.51 Typical High $7.08 | Professional | None | $0.36 | $0.51 | $7.08 |
United Setting Professional Modifier None Typical Low $0.28 Median $0.41 Typical High $0.76 | Professional | None | $0.28 | $0.41 | $0.76 |
2 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 55 · Aftercare only Typical Low $0.04 Median $0.06 Typical High $0.10 | Professional | 55 · Aftercare only | $0.04 | $0.06 | $0.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.04 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.03 | $0.04 | $0.07 |
Where Missouri sits
The same service costs 190.5 times more in Wyoming 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· 14th of 51
$1.00
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.