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 $0.15 Median $0.15 Typical High $0.15 | Facility | None | $0.15 | $0.15 | $0.15 |
Aetna Setting Professional Modifier None Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | None | $0.15 | $0.15 | $0.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.10 Median $1.70 Typical High $1.70 | Professional | None | $0.10 | $1.70 | $1.70 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | UE · Used equipment | $1.29 | $1.29 | $1.29 |
Cigna Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | None | $0.02 | $0.02 | $0.02 |
Medica Setting Facility Modifier None Typical Low $0.12 Median $89.13 Typical High $100.00 | Facility | None | $0.12 | $89.13 | $100.00 |
Medica Setting Professional Modifier None Typical Low $0.18 Median $0.21 Typical High $0.39 | Professional | None | $0.18 | $0.21 | $0.39 |
United Setting Professional Modifier None Typical Low $0.14 Median $0.21 Typical High $0.36 | Professional | None | $0.14 | $0.21 | $0.36 |
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 $0.02 Median $0.02 Typical High $0.02 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.02 |
Where Missouri sits
The same service costs 24.5 times more in North Carolina than in Oregon. 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· 23rd of 51
$0.21
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.