How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $0.74 Median $0.74 Typical High $0.74 | Facility | None | $0.74 | $0.74 | $0.74 |
Aetna Setting Professional Modifier None Typical Low $0.74 Median $0.74 Typical High $0.74 | Professional | None | $0.74 | $0.74 | $0.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.79 Median $0.87 Typical High $0.87 | Professional | None | $0.79 | $0.87 | $0.87 |
Cigna Setting Facility Modifier None Typical Low $0.81 Median $1.32 Typical High $1.48 | Facility | None | $0.81 | $1.32 | $1.48 |
Cigna Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | None | $0.79 | $0.79 | $0.79 |
Medica Setting Facility Modifier None Typical Low $0.74 Median $0.91 Typical High $1.00 | Facility | None | $0.74 | $0.91 | $1.00 |
Medica Setting Professional Modifier None Typical Low $0.74 Median $0.79 Typical High $0.87 | Professional | None | $0.74 | $0.79 | $0.87 |
United Setting Professional Modifier None Typical Low $0.71 Median $0.79 Typical High $0.91 | Professional | None | $0.71 | $0.79 | $0.91 |
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 $0.37 Median $0.37 Typical High $0.37 | Professional | 52 · Reduced service | $0.37 | $0.37 | $0.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | 53 · Discontinued | $0.15 | $0.15 | $0.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 55 · Aftercare only | $0.11 | $0.11 | $0.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.07 | $0.07 | $0.07 |
Where Missouri sits
The same service costs 14.5 times more in Kansas than in Montana. 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
$0.79
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.