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 $0.28 Median $0.69 Typical High $0.69 | Facility | None | $0.28 | $0.69 | $0.69 |
Aetna Setting Professional Modifier None Typical Low $0.30 Median $0.65 Typical High $0.69 | Professional | None | $0.30 | $0.65 | $0.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.10 Median $0.81 Typical High $2.00 | Professional | None | $0.10 | $0.81 | $2.00 |
Cigna Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
Medica Setting Facility Modifier None Typical Low $0.36 Median $1.29 Typical High $89.13 | Facility | None | $0.36 | $1.29 | $89.13 |
Medica Setting Professional Modifier None Typical Low $0.39 Median $5.25 Typical High $5.25 | Professional | None | $0.39 | $5.25 | $5.25 |
United Setting Professional Modifier None Typical Low $0.28 Median $0.40 Typical High $0.71 | Professional | None | $0.28 | $0.40 | $0.71 |
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 $0.05 Median $0.10 Typical High $0.10 | Professional | 55 · Aftercare only | $0.05 | $0.10 | $0.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.07 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.03 | $0.07 | $0.07 |
Where Missouri sits
The same service costs 2.9 times more in Minnesota than in Ohio. 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· 16th of 51
$0.76
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.