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 $3.55 Median $4.17 Typical High $5.75 | Facility | None | $3.55 | $4.17 | $5.75 |
Aetna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $4.27 | Professional | None | $3.55 | $3.55 | $4.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.72 Median $4.79 Typical High $12.30 | Facility | None | $3.72 | $4.79 | $12.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.55 Median $3.89 Typical High $4.17 | Professional | None | $3.55 | $3.89 | $4.17 |
Cigna Setting Facility Modifier None Typical Low $4.07 Median $6.03 Typical High $8.32 | Facility | None | $4.07 | $6.03 | $8.32 |
Cigna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
Medica Setting Facility Modifier None Typical Low $3.55 Median $3.63 Typical High $4.79 | Facility | None | $3.55 | $3.63 | $4.79 |
Medica Setting Professional Modifier None Typical Low $3.47 Median $3.55 Typical High $4.07 | Professional | None | $3.47 | $3.55 | $4.07 |
United Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.55 Typical High $3.98 | Professional | None | $3.24 | $3.55 | $3.98 |
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 $1.78 Median $1.78 Typical High $2.09 | Professional | 52 · Reduced service | $1.78 | $1.78 | $2.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.71 Median $0.71 Typical High $0.83 | Professional | 53 · Discontinued | $0.71 | $0.71 | $0.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.52 Typical High $0.63 | Professional | 55 · Aftercare only | $0.52 | $0.52 | $0.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.35 Typical High $0.42 | Professional | 56 · Pre-op care only | $0.35 | $0.35 | $0.42 |
Where Missouri sits
The same service costs 1.7 times more in Arizona than in Illinois. 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· 25th of 51
$3.55
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.