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 $4.27 Median $7.08 Typical High $9.77 | Facility | None | $4.27 | $7.08 | $9.77 |
Aetna Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $7.08 | Professional | None | $4.37 | $4.37 | $7.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.47 Median $5.89 Typical High $14.79 | Facility | None | $4.47 | $5.89 | $14.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.27 Median $4.68 Typical High $7.08 | Professional | None | $4.27 | $4.68 | $7.08 |
Cigna Setting Facility Modifier None Typical Low $5.01 Median $7.59 Typical High $10.23 | Facility | None | $5.01 | $7.59 | $10.23 |
Cigna Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | None | $4.37 | $4.37 | $4.37 |
Medica Setting Facility Modifier None Typical Low $3.89 Median $4.47 Typical High $7.41 | Facility | None | $3.89 | $4.47 | $7.41 |
Medica Setting Professional Modifier None Typical Low $3.80 Median $4.27 Typical High $4.90 | Professional | None | $3.80 | $4.27 | $4.90 |
United Setting Facility Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Facility | None | $4.37 | $4.37 | $4.37 |
United Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $5.25 | Professional | None | $4.27 | $4.27 | $5.25 |
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 $2.19 Median $2.19 Typical High $3.55 | Professional | 52 · Reduced service | $2.19 | $2.19 | $3.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.87 Median $0.87 Typical High $1.41 | Professional | 53 · Discontinued | $0.87 | $0.87 | $1.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.66 Median $0.66 Typical High $1.05 | Professional | 55 · Aftercare only | $0.66 | $0.66 | $1.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.44 Median $0.44 Typical High $0.71 | Professional | 56 · Pre-op care only | $0.44 | $0.44 | $0.71 |
Where Missouri sits
The same service costs 2.7 times more in Alaska than in Oklahoma. 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
$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.