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 $1.12 Median $2.63 Typical High $2.63 | Facility | None | $1.12 | $2.63 | $2.63 |
Aetna Setting Professional Modifier None Typical Low $1.12 Median $1.58 Typical High $2.63 | Professional | None | $1.12 | $1.58 | $2.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.17 Median $1.58 Typical High $2.24 | Professional | None | $1.17 | $1.58 | $2.24 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.87 Median $1.12 Typical High $1.86 | Professional | UE · Used equipment | $0.87 | $1.12 | $1.86 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $2.63 | Professional | None | $1.58 | $1.58 | $2.63 |
Cigna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | None | $1.32 | $1.32 | $1.32 |
Medica Setting Facility Modifier None Typical Low $1.45 Median $3.16 Typical High $79.43 | Facility | None | $1.45 | $3.16 | $79.43 |
Medica Setting Professional Modifier None Typical Low $0.93 Median $1.32 Typical High $12.88 | Professional | None | $0.93 | $1.32 | $12.88 |
United Setting Professional Modifier None Typical Low $0.87 Median $1.29 Typical High $2.14 | Professional | None | $0.87 | $1.29 | $2.14 |
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 $0.56 Median $0.79 Typical High $1.32 | Professional | 52 · Reduced service | $0.56 | $0.79 | $1.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.22 Median $0.32 Typical High $0.52 | Professional | 53 · Discontinued | $0.22 | $0.32 | $0.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.17 Median $0.24 Typical High $0.39 | Professional | 55 · Aftercare only | $0.17 | $0.24 | $0.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.16 Typical High $0.26 | Professional | 56 · Pre-op care only | $0.11 | $0.16 | $0.26 |
Where Missouri sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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· 25th of 51
$1.58
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.