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 $9.33 Median $9.33 Typical High $10.72 | Facility | None | $9.33 | $9.33 | $10.72 |
Aetna Setting Professional Modifier None Typical Low $5.89 Median $9.33 Typical High $10.72 | Professional | None | $5.89 | $9.33 | $10.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $11.22 Median $11.22 Typical High $39.81 | Facility | None | $11.22 | $11.22 | $39.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.90 Median $7.08 Typical High $12.59 | Professional | None | $4.90 | $7.08 | $12.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.02 Median $3.98 Typical High $7.94 | Professional | UE · Used equipment | $3.02 | $3.98 | $7.94 |
Cigna Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | None | $5.13 | $5.13 | $5.13 |
Medica Setting Facility Modifier None Typical Low $5.75 Median $22.91 Typical High $85.11 | Facility | None | $5.75 | $22.91 | $85.11 |
Medica Setting Professional Modifier None Typical Low $4.27 Median $7.24 Typical High $13.49 | Professional | None | $4.27 | $7.24 | $13.49 |
United Setting Professional Modifier None Typical Low $3.72 Median $8.13 Typical High $15.14 | Professional | None | $3.72 | $8.13 | $15.14 |
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 $0.89 Median $1.38 Typical High $1.58 | Professional | 55 · Aftercare only | $0.89 | $1.38 | $1.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.59 Median $0.93 Typical High $1.07 | Professional | 56 · Pre-op care only | $0.59 | $0.93 | $1.07 |
Where Missouri sits
The same service costs 4.7 times more in Florida than in New York. 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· 39th of 51
$8.13
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.