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 $2.00 Median $2.82 Typical High $6.61 | Professional | None | $2.00 | $2.82 | $6.61 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.62 Median $4.90 Typical High $4.90 | Professional | UE · Used equipment | $1.62 | $4.90 | $4.90 |
BCBS Kansas City Setting Professional Modifier None Typical Low $4.68 Median $5.01 Typical High $5.89 | Professional | None | $4.68 | $5.01 | $5.89 |
Cigna Setting Professional Modifier None Typical Low $0.87 Median $1.66 Typical High $1.70 | Professional | None | $0.87 | $1.66 | $1.70 |
Medica Setting Facility Modifier None Typical Low $1.12 Median $3.89 Typical High $89.13 | Facility | None | $1.12 | $3.89 | $89.13 |
Medica Setting Professional Modifier None Typical Low $1.10 Median $1.70 Typical High $17.78 | Professional | None | $1.10 | $1.70 | $17.78 |
United Setting Professional Modifier None Typical Low $0.83 Median $1.26 Typical High $2.63 | Professional | None | $0.83 | $1.26 | $2.63 |
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 6.6 times more in Kentucky than in West Virginia. 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· 18th of 51
$2.04
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.