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 $0.19 Median $0.44 Typical High $6.76 | Facility | None | $0.19 | $0.44 | $6.76 |
Aetna Setting Professional Modifier None Typical Low $0.19 Median $0.27 Typical High $0.44 | Professional | None | $0.19 | $0.27 | $0.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.27 Median $0.27 Typical High $0.41 | Professional | None | $0.27 | $0.27 | $0.41 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.15 Median $0.20 Typical High $0.35 | Professional | UE · Used equipment | $0.15 | $0.20 | $0.35 |
BCBS Kansas City Setting Professional Modifier None Typical Low $0.27 Median $0.27 Typical High $0.45 | Professional | None | $0.27 | $0.27 | $0.45 |
Cigna Setting Professional Modifier None Typical Low $0.22 Median $0.22 Typical High $0.22 | Professional | None | $0.22 | $0.22 | $0.22 |
Medica Setting Facility Modifier None Typical Low $0.24 Median $0.52 Typical High $79.43 | Facility | None | $0.24 | $0.52 | $79.43 |
Medica Setting Professional Modifier None Typical Low $0.16 Median $0.22 Typical High $2.19 | Professional | None | $0.16 | $0.22 | $2.19 |
United Setting Professional Modifier None Typical Low $0.15 Median $0.22 Typical High $0.34 | Professional | None | $0.15 | $0.22 | $0.34 |
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 $0.10 Median $0.14 Typical High $0.22 | Professional | 52 · Reduced service | $0.10 | $0.14 | $0.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.04 Median $0.05 Typical High $0.09 | Professional | 53 · Discontinued | $0.04 | $0.05 | $0.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.03 Median $0.04 Typical High $0.07 | Professional | 55 · Aftercare only | $0.03 | $0.04 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.03 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.02 | $0.03 | $0.04 |
Where Missouri sits
The same service costs 2.5 times more in Hawaii than in Utah. 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· 26th of 51
$0.27
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.