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 $0.87 Median $2.04 Typical High $2.04 | Facility | None | $0.87 | $2.04 | $2.04 |
Aetna Setting Professional Modifier None Typical Low $0.87 Median $1.26 Typical High $2.04 | Professional | None | $0.87 | $1.26 | $2.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.35 Median $2.19 Typical High $3.16 | Professional | None | $1.35 | $2.19 | $3.16 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.74 Median $2.40 Typical High $2.82 | Professional | UE · Used equipment | $1.74 | $2.40 | $2.82 |
BCBS Kansas City Setting Professional Modifier None Typical Low $3.72 Median $3.89 Typical High $5.25 | Professional | None | $3.72 | $3.89 | $5.25 |
Cigna Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
Medica Setting Facility Modifier None Typical Low $1.12 Median $75.86 Typical High $100.00 | Facility | None | $1.12 | $75.86 | $100.00 |
Medica Setting Professional Modifier None Typical Low $1.10 Median $1.51 Typical High $15.85 | Professional | None | $1.10 | $1.51 | $15.85 |
United Setting Professional Modifier None Typical Low $0.83 Median $1.26 Typical High $2.40 | Professional | None | $0.83 | $1.26 | $2.40 |
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 $0.13 Median $0.19 Typical High $0.31 | Professional | 55 · Aftercare only | $0.13 | $0.19 | $0.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.13 Typical High $0.21 | Professional | 56 · Pre-op care only | $0.09 | $0.13 | $0.21 |
Where Missouri sits
The same service costs 6.0 times more in Minnesota 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· 21st of 51
$2.19
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.