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 $2.57 Median $3.16 Typical High $4.37 | Facility | None | $2.57 | $3.16 | $4.37 |
Aetna Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $3.24 | Professional | None | $2.69 | $2.69 | $3.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.69 Median $3.63 Typical High $7.08 | Facility | None | $2.69 | $3.63 | $7.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.57 Median $2.88 Typical High $3.16 | Professional | None | $2.57 | $2.88 | $3.16 |
Cigna Setting Facility Modifier None Typical Low $3.09 Median $4.57 Typical High $6.31 | Facility | None | $3.09 | $4.57 | $6.31 |
Cigna Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | None | $2.69 | $2.69 | $2.69 |
Medica Setting Facility Modifier None Typical Low $2.51 Median $2.63 Typical High $3.63 | Facility | None | $2.51 | $2.63 | $3.63 |
Medica Setting Professional Modifier None Typical Low $2.34 Median $2.63 Typical High $2.95 | Professional | None | $2.34 | $2.63 | $2.95 |
United Setting Professional Modifier None Typical Low $2.51 Median $2.57 Typical High $3.02 | Professional | None | $2.51 | $2.57 | $3.02 |
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 $1.35 Median $1.35 Typical High $1.62 | Professional | 52 · Reduced service | $1.35 | $1.35 | $1.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.54 Median $0.54 Typical High $0.65 | Professional | 53 · Discontinued | $0.54 | $0.54 | $0.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.40 Median $0.40 Typical High $0.48 | Professional | 55 · Aftercare only | $0.40 | $0.40 | $0.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.27 Median $0.27 Typical High $0.32 | Professional | 56 · Pre-op care only | $0.27 | $0.27 | $0.32 |
Where Missouri sits
The same service costs 1.7 times more in Arizona than in Rhode Island. 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· 24th of 51
$2.69
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.