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 $1.91 Median $4.47 Typical High $4.47 | Facility | None | $1.91 | $4.47 | $4.47 |
Aetna Setting Professional Modifier None Typical Low $1.91 Median $2.45 Typical High $4.47 | Professional | None | $1.91 | $2.45 | $4.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.71 Median $3.98 Typical High $9.77 | Professional | None | $0.71 | $3.98 | $9.77 |
Cigna Setting Facility Modifier None Typical Low $4.17 Median $6.17 Typical High $6.92 | Facility | None | $4.17 | $6.17 | $6.92 |
Cigna Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | None | $3.72 | $3.72 | $3.72 |
Medica Setting Facility Modifier None Typical Low $2.34 Median $8.32 Typical High $89.13 | Facility | None | $2.34 | $8.32 | $89.13 |
Medica Setting Professional Modifier None Typical Low $2.34 Median $5.75 Typical High $28.18 | Professional | None | $2.34 | $5.75 | $28.18 |
United Setting Professional Modifier None Typical Low $1.74 Median $2.69 Typical High $6.76 | Professional | None | $1.74 | $2.69 | $6.76 |
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 $0.95 Median $1.23 Typical High $2.24 | Professional | 52 · Reduced service | $0.95 | $1.23 | $2.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.38 Median $0.49 Typical High $0.89 | Professional | 53 · Discontinued | $0.38 | $0.49 | $0.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.28 Median $0.36 Typical High $0.68 | Professional | 55 · Aftercare only | $0.28 | $0.36 | $0.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.24 Typical High $0.45 | Professional | 56 · Pre-op care only | $0.19 | $0.24 | $0.45 |
Where Missouri sits
The same service costs 4.6 times more in Ohio than in Hawaii. 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· 32nd of 51
$3.72
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.