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 $3.98 Median $3.98 Typical High $4.57 | Facility | None | $3.98 | $3.98 | $4.57 |
Aetna Setting Professional Modifier None Typical Low $2.00 Median $3.98 Typical High $4.57 | Professional | None | $2.00 | $3.98 | $4.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.80 Median $3.80 Typical High $13.49 | Facility | None | $3.80 | $3.80 | $13.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.24 Median $4.17 Typical High $16.98 | Professional | None | $3.24 | $4.17 | $16.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.04 Median $2.40 Typical High $3.55 | Professional | UE · Used equipment | $2.04 | $2.40 | $3.55 |
Cigna Setting Professional Modifier None Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | None | $1.62 | $1.62 | $1.62 |
Medica Setting Facility Modifier None Typical Low $4.07 Median $7.76 Typical High $85.11 | Facility | None | $4.07 | $7.76 | $85.11 |
Medica Setting Professional Modifier None Typical Low $1.82 Median $4.79 Typical High $7.76 | Professional | None | $1.82 | $4.79 | $7.76 |
United Setting Professional Modifier None Typical Low $1.58 Median $4.79 Typical High $8.71 | Professional | None | $1.58 | $4.79 | $8.71 |
2 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 55 · Aftercare only Typical Low $0.30 Median $0.59 Typical High $0.68 | Professional | 55 · Aftercare only | $0.30 | $0.59 | $0.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.39 Typical High $0.45 | Professional | 56 · Pre-op care only | $0.20 | $0.39 | $0.45 |
Where Missouri sits
The same service costs 5.2 times more in Kansas than in Delaware. 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
$4.17
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.