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 $9.55 Median $9.55 Typical High $10.96 | Facility | None | $9.55 | $9.55 | $10.96 |
Aetna Setting Professional Modifier None Typical Low $6.17 Median $9.55 Typical High $10.96 | Professional | None | $6.17 | $9.55 | $10.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $41.69 | Facility | None | $11.48 | $11.48 | $41.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.17 Median $4.27 Typical High $11.48 | Professional | None | $4.17 | $4.27 | $11.48 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.09 Median $3.24 Typical High $8.91 | Professional | UE · Used equipment | $3.09 | $3.24 | $8.91 |
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 $23.44 Typical High $85.11 | Facility | None | $5.75 | $23.44 | $85.11 |
Medica Setting Professional Modifier None Typical Low $4.47 Median $7.59 Typical High $13.80 | Professional | None | $4.47 | $7.59 | $13.80 |
United Setting Professional Modifier None Typical Low $3.89 Median $8.32 Typical High $15.49 | Professional | None | $3.89 | $8.32 | $15.49 |
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 $0.91 Median $1.45 Typical High $1.66 | Professional | 55 · Aftercare only | $0.91 | $1.45 | $1.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.62 Median $0.95 Typical High $1.12 | Professional | 56 · Pre-op care only | $0.62 | $0.95 | $1.12 |
Where Missouri sits
The same service costs 4.6 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· 45th of 51
$6.61
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.