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 $5.37 Median $5.37 Typical High $6.17 | Facility | None | $5.37 | $5.37 | $6.17 |
Aetna Setting Professional Modifier None Typical Low $2.75 Median $5.37 Typical High $6.17 | Professional | None | $2.75 | $5.37 | $6.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.13 Median $5.13 Typical High $18.62 | Facility | None | $5.13 | $5.13 | $18.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.37 Median $5.37 Typical High $16.98 | Professional | None | $4.37 | $5.37 | $16.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.82 Median $3.31 Typical High $4.07 | Professional | UE · Used equipment | $2.82 | $3.31 | $4.07 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | None | $2.57 | $2.57 | $2.57 |
Medica Setting Facility Modifier None Typical Low $5.13 Median $10.47 Typical High $85.11 | Facility | None | $5.13 | $10.47 | $85.11 |
Medica Setting Professional Modifier None Typical Low $2.45 Median $6.31 Typical High $10.47 | Professional | None | $2.45 | $6.31 | $10.47 |
United Setting Professional Modifier None Typical Low $2.14 Median $6.17 Typical High $11.48 | Professional | None | $2.14 | $6.17 | $11.48 |
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 $0.41 Median $0.79 Typical High $0.91 | Professional | 55 · Aftercare only | $0.41 | $0.79 | $0.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.27 Median $0.52 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.27 | $0.52 | $0.62 |
Where Missouri sits
The same service costs 4.2 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· 27th of 51
$5.50
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.