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 $2.04 Median $4.79 Typical High $4.79 | Facility | None | $2.04 | $4.79 | $4.79 |
Aetna Setting Professional Modifier None Typical Low $2.04 Median $2.88 Typical High $4.79 | Professional | None | $2.04 | $2.88 | $4.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.14 Median $2.40 Typical High $4.68 | Professional | None | $2.14 | $2.40 | $4.68 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.62 Median $2.14 Typical High $3.16 | Professional | UE · Used equipment | $1.62 | $2.14 | $3.16 |
BCBS Kansas City Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $4.90 | Professional | None | $2.95 | $2.95 | $4.90 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | None | $2.00 | $2.00 | $2.00 |
Medica Setting Facility Modifier None Typical Low $2.51 Median $9.55 Typical High $79.43 | Facility | None | $2.51 | $9.55 | $79.43 |
Medica Setting Professional Modifier None Typical Low $1.70 Median $2.40 Typical High $23.44 | Professional | None | $1.70 | $2.40 | $23.44 |
United Setting Professional Modifier None Typical Low $1.58 Median $2.34 Typical High $3.89 | Professional | None | $1.58 | $2.34 | $3.89 |
4 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 $1.02 Median $1.45 Typical High $2.40 | Professional | 52 · Reduced service | $1.02 | $1.45 | $2.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.41 Median $0.58 Typical High $0.95 | Professional | 53 · Discontinued | $0.41 | $0.58 | $0.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.31 Median $0.44 Typical High $0.71 | Professional | 55 · Aftercare only | $0.31 | $0.44 | $0.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.28 Typical High $0.48 | Professional | 56 · Pre-op care only | $0.20 | $0.28 | $0.48 |
Where Missouri sits
The same service costs 2.6 times more in Hawaii than in Maine. 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· 37th of 51
$2.40
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.