How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $4.07 Median $4.07 Typical High $4.07 | Facility | None | $4.07 | $4.07 | $4.07 |
Aetna Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | None | $4.07 | $4.07 | $4.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $28.18 | Professional | None | $14.45 | $14.45 | $28.18 |
BCBS Kansas City Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $27.54 | Professional | None | $16.22 | $16.22 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | None | $13.49 | $13.49 | $13.49 |
Medica Setting Facility Modifier None Typical Low $4.07 Median $32.36 Typical High $114.82 | Facility | None | $4.07 | $32.36 | $114.82 |
Medica Setting Professional Modifier None Typical Low $10.00 Median $14.13 Typical High $134.90 | Professional | None | $10.00 | $14.13 | $134.90 |
United Setting Professional Modifier None Typical Low $9.33 Median $14.13 Typical High $23.44 | Professional | None | $9.33 | $14.13 | $23.44 |
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 $2.04 Median $2.04 Typical High $2.04 | Professional | 52 · Reduced service | $2.04 | $2.04 | $2.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.81 Median $0.81 Typical High $0.81 | Professional | 53 · Discontinued | $0.81 | $0.81 | $0.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.62 Median $0.62 Typical High $0.62 | Professional | 55 · Aftercare only | $0.62 | $0.62 | $0.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.41 Median $0.41 Typical High $0.41 | Professional | 56 · Pre-op care only | $0.41 | $0.41 | $0.41 |
Where Missouri sits
The same service costs 6.9 times more in Montana than in Indiana. 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
$14.45
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.