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 $13.18 Median $13.80 Typical High $18.62 | Facility | None | $13.18 | $13.80 | $18.62 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $15.85 | Professional | None | $13.18 | $13.18 | $15.85 |
Anthem BCBS Setting Facility Modifier None Typical Low $13.80 Median $17.78 Typical High $46.77 | Facility | None | $13.80 | $17.78 | $46.77 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.18 Median $14.45 Typical High $15.14 | Professional | None | $13.18 | $14.45 | $15.14 |
Cigna Setting Facility Modifier None Typical Low $15.14 Median $22.91 Typical High $31.62 | Facility | None | $15.14 | $22.91 | $31.62 |
Cigna Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | None | $13.18 | $13.18 | $13.18 |
Medica Setting Facility Modifier None Typical Low $12.88 Median $15.14 Typical High $100.00 | Facility | None | $12.88 | $15.14 | $100.00 |
Medica Setting Professional Modifier None Typical Low $12.02 Median $13.49 Typical High $14.79 | Professional | None | $12.02 | $13.49 | $14.79 |
United Setting Facility Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Facility | None | $13.18 | $13.18 | $13.18 |
United Setting Professional Modifier None Typical Low $12.30 Median $13.18 Typical High $15.14 | Professional | None | $12.30 | $13.18 | $15.14 |
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 $6.61 Median $6.61 Typical High $7.94 | Professional | 52 · Reduced service | $6.61 | $6.61 | $7.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $2.63 Typical High $3.16 | Professional | 53 · Discontinued | $2.63 | $2.63 | $3.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.00 Median $2.00 Typical High $2.40 | Professional | 55 · Aftercare only | $2.00 | $2.00 | $2.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $1.32 Typical High $1.58 | Professional | 56 · Pre-op care only | $1.32 | $1.32 | $1.58 |
Where Missouri sits
The same service costs 1.5 times more in Alaska 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· 26th of 51
$13.49
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.