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 $0.83 Median $1.95 Typical High $1.95 | Facility | None | $0.83 | $1.95 | $1.95 |
Aetna Setting Professional Modifier None Typical Low $0.83 Median $1.20 Typical High $1.95 | Professional | None | $0.83 | $1.20 | $1.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.85 Median $1.17 Typical High $1.66 | Professional | None | $0.85 | $1.17 | $1.66 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.65 Median $1.10 Typical High $1.29 | Professional | UE · Used equipment | $0.65 | $1.10 | $1.29 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1.20 Median $1.20 Typical High $2.00 | Professional | None | $1.20 | $1.20 | $2.00 |
Cigna Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | None | $1.00 | $1.00 | $1.00 |
Medica Setting Facility Modifier None Typical Low $1.07 Median $2.34 Typical High $79.43 | Facility | None | $1.07 | $2.34 | $79.43 |
Medica Setting Professional Modifier None Typical Low $0.69 Median $0.98 Typical High $9.77 | Professional | None | $0.69 | $0.98 | $9.77 |
United Setting Professional Modifier None Typical Low $0.65 Median $0.98 Typical High $1.58 | Professional | None | $0.65 | $0.98 | $1.58 |
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 $0.42 Median $0.60 Typical High $0.98 | Professional | 52 · Reduced service | $0.42 | $0.60 | $0.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.17 Median $0.24 Typical High $0.39 | Professional | 53 · Discontinued | $0.17 | $0.24 | $0.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.18 Typical High $0.28 | Professional | 55 · Aftercare only | $0.12 | $0.18 | $0.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.12 Typical High $0.19 | Professional | 56 · Pre-op care only | $0.08 | $0.12 | $0.19 |
Where Missouri sits
The same service costs 2.6 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· 25th of 51
$1.17
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.