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 $0.41 Median $0.95 Typical High $0.95 | Facility | None | $0.41 | $0.95 | $0.95 |
Aetna Setting Professional Modifier None Typical Low $0.41 Median $0.58 Typical High $0.95 | Professional | None | $0.41 | $0.58 | $0.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.42 Median $0.56 Typical High $0.83 | Professional | None | $0.42 | $0.56 | $0.83 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.32 Median $0.44 Typical High $0.68 | Professional | UE · Used equipment | $0.32 | $0.44 | $0.68 |
BCBS Kansas City Setting Professional Modifier None Typical Low $0.58 Median $0.58 Typical High $0.98 | Professional | None | $0.58 | $0.58 | $0.98 |
Cigna Setting Professional Modifier None Typical Low $0.49 Median $0.49 Typical High $0.49 | Professional | None | $0.49 | $0.49 | $0.49 |
Medica Setting Facility Modifier None Typical Low $0.52 Median $1.12 Typical High $79.43 | Facility | None | $0.52 | $1.12 | $79.43 |
Medica Setting Professional Modifier None Typical Low $0.34 Median $0.48 Typical High $4.68 | Professional | None | $0.34 | $0.48 | $4.68 |
United Setting Professional Modifier None Typical Low $0.32 Median $0.47 Typical High $0.78 | Professional | None | $0.32 | $0.47 | $0.78 |
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 $0.21 Median $0.28 Typical High $0.48 | Professional | 52 · Reduced service | $0.21 | $0.28 | $0.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.08 Median $0.12 Typical High $0.19 | Professional | 53 · Discontinued | $0.08 | $0.12 | $0.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.09 Typical High $0.14 | Professional | 55 · Aftercare only | $0.06 | $0.09 | $0.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.06 Typical High $0.10 | Professional | 56 · Pre-op care only | $0.04 | $0.06 | $0.10 |
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
$0.56
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.