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 $4.17 Median $5.25 Typical High $5.25 | Facility | None | $4.17 | $5.25 | $5.25 |
Aetna Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $5.25 | Professional | None | $4.17 | $4.17 | $5.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.51 Median $5.01 Typical High $11.48 | Facility | None | $2.51 | $5.01 | $11.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.89 Median $5.25 Typical High $5.25 | Professional | None | $3.89 | $5.25 | $5.25 |
Cigna Setting Facility Modifier None Typical Low $5.01 Median $7.24 Typical High $8.32 | Facility | None | $5.01 | $7.24 | $8.32 |
Cigna Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | None | $4.47 | $4.47 | $4.47 |
Medica Setting Facility Modifier None Typical Low $3.98 Median $4.47 Typical High $5.13 | Facility | None | $3.98 | $4.47 | $5.13 |
Medica Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $4.79 | Professional | None | $4.17 | $4.17 | $4.79 |
United Setting Facility Modifier None Typical Low $2.45 Median $2.45 Typical High $2.45 | Facility | None | $2.45 | $2.45 | $2.45 |
United Setting Professional Modifier None Typical Low $4.17 Median $4.37 Typical High $5.01 | Professional | None | $4.17 | $4.37 | $5.01 |
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 $2.09 Median $2.09 Typical High $2.57 | Professional | 52 · Reduced service | $2.09 | $2.09 | $2.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.83 Median $0.83 Typical High $1.05 | Professional | 53 · Discontinued | $0.83 | $0.83 | $1.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.62 Median $0.62 Typical High $0.78 | Professional | 55 · Aftercare only | $0.62 | $0.62 | $0.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.42 Median $0.42 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.42 | $0.42 | $0.52 |
Where Missouri sits
The same service costs 1.8 times more in Alaska than in Kentucky. 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· 29th of 51
$4.37
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.