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 $8.13 Median $9.55 Typical High $9.77 | Facility | None | $8.13 | $9.55 | $9.77 |
Aetna Setting Professional Modifier None Typical Low $7.08 Median $9.55 Typical High $9.77 | Professional | None | $7.08 | $9.55 | $9.77 |
BCBS Setting Facility Modifier None Typical Low $8.32 Median $8.71 Typical High $8.71 | Facility | None | $8.32 | $8.71 | $8.71 |
BCBS Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | None | $7.41 | $7.41 | $7.41 |
Cigna Setting Facility Modifier None Typical Low $7.24 Median $20.89 Typical High $27.54 | Facility | None | $7.24 | $20.89 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
Medica Setting Facility Modifier None Typical Low $6.46 Median $8.51 Typical High $9.55 | Facility | None | $6.46 | $8.51 | $9.55 |
Medica Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $10.96 | Professional | None | $6.92 | $6.92 | $10.96 |
United Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $11.75 | Professional | None | $6.92 | $6.92 | $11.75 |
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 $3.55 Median $4.79 Typical High $4.79 | Professional | 52 · Reduced service | $3.55 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.45 Median $1.95 Typical High $1.95 | Professional | 53 · Discontinued | $1.45 | $1.95 | $1.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.07 Median $1.45 Typical High $1.45 | Professional | 55 · Aftercare only | $1.07 | $1.45 | $1.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.71 Median $0.95 Typical High $0.98 | Professional | 56 · Pre-op care only | $0.71 | $0.95 | $0.98 |
Where Kansas sits
The same service costs 2.0 times more in Alaska than in Maryland. 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.
Kansas· 12th of 51
$8.32
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.