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 $1.05 Median $2.45 Typical High $2.45 | Facility | None | $1.05 | $2.45 | $2.45 |
Aetna Setting Professional Modifier None Typical Low $1.05 Median $1.48 Typical High $2.45 | Professional | None | $1.05 | $1.48 | $2.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.29 Median $2.19 Typical High $3.24 | Professional | None | $1.29 | $2.19 | $3.24 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.95 Median $1.38 Typical High $3.24 | Professional | UE · Used equipment | $0.95 | $1.38 | $3.24 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $2.51 | Professional | None | $1.51 | $1.51 | $2.51 |
Cigna Setting Professional Modifier None Typical Low $1.02 Median $1.12 Typical High $1.12 | Professional | None | $1.02 | $1.12 | $1.12 |
Medica Setting Facility Modifier None Typical Low $1.35 Median $5.01 Typical High $89.13 | Facility | None | $1.35 | $5.01 | $89.13 |
Medica Setting Professional Modifier None Typical Low $0.87 Median $1.23 Typical High $12.30 | Professional | None | $0.87 | $1.23 | $12.30 |
United Setting Professional Modifier None Typical Low $0.81 Median $1.23 Typical High $2.14 | Professional | None | $0.81 | $1.23 | $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 $0.52 Median $0.76 Typical High $1.23 | Professional | 52 · Reduced service | $0.52 | $0.76 | $1.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.21 Median $0.30 Typical High $0.49 | Professional | 53 · Discontinued | $0.21 | $0.30 | $0.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.16 Median $0.22 Typical High $0.37 | Professional | 55 · Aftercare only | $0.16 | $0.22 | $0.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.15 Typical High $0.25 | Professional | 56 · Pre-op care only | $0.11 | $0.15 | $0.25 |
Where Missouri sits
The same service costs 4.6 times more in Rhode Island 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· 29th of 51
$1.51
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.