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 $6.92 Median $8.51 Typical High $11.75 | Facility | None | $6.92 | $8.51 | $11.75 |
Aetna Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $8.91 | Professional | None | $7.59 | $7.59 | $8.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $7.41 Median $10.23 Typical High $23.99 | Facility | None | $7.41 | $10.23 | $23.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.92 Median $7.59 Typical High $8.51 | Professional | None | $6.92 | $7.59 | $8.51 |
Cigna Setting Facility Modifier None Typical Low $8.51 Median $12.88 Typical High $17.78 | Facility | None | $8.51 | $12.88 | $17.78 |
Cigna Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | None | $7.59 | $7.59 | $7.59 |
Medica Setting Facility Modifier None Typical Low $6.76 Median $7.08 Typical High $75.86 | Facility | None | $6.76 | $7.08 | $75.86 |
Medica Setting Professional Modifier None Typical Low $5.75 Median $6.76 Typical High $6.76 | Professional | None | $5.75 | $6.76 | $6.76 |
United Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Facility | None | $7.59 | $7.59 | $7.59 |
United Setting Professional Modifier None Typical Low $5.62 Median $6.92 Typical High $7.94 | Professional | None | $5.62 | $6.92 | $7.94 |
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 $3.80 Median $3.80 Typical High $4.47 | Professional | 52 · Reduced service | $3.80 | $3.80 | $4.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.51 Median $1.51 Typical High $1.82 | Professional | 53 · Discontinued | $1.51 | $1.51 | $1.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.12 Median $1.12 Typical High $1.35 | Professional | 55 · Aftercare only | $1.12 | $1.12 | $1.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.76 Median $0.76 Typical High $0.89 | Professional | 56 · Pre-op care only | $0.76 | $0.76 | $0.89 |
Where Missouri sits
The same service costs 1.9 times more in Alaska than in Rhode Island. 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
$7.59
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.