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 $4.07 Median $7.08 Typical High $10.47 | Facility | None | $4.07 | $7.08 | $10.47 |
Aetna Setting Professional Modifier None Typical Low $3.89 Median $3.98 Typical High $10.47 | Professional | None | $3.89 | $3.98 | $10.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.89 Median $6.61 Typical High $17.78 | Facility | None | $3.89 | $6.61 | $17.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.89 Median $7.08 Typical High $11.48 | Professional | None | $3.89 | $7.08 | $11.48 |
Cigna Setting Facility Modifier None Typical Low $4.47 Median $6.92 Typical High $9.33 | Facility | None | $4.47 | $6.92 | $9.33 |
Cigna Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | None | $3.89 | $3.89 | $3.89 |
Medica Setting Facility Modifier None Typical Low $4.07 Median $8.91 Typical High $13.80 | Facility | None | $4.07 | $8.91 | $13.80 |
Medica Setting Professional Modifier None Typical Low $3.63 Median $3.98 Typical High $4.68 | Professional | None | $3.63 | $3.98 | $4.68 |
United Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $11.75 | Professional | None | $10.47 | $10.47 | $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 $1.95 Median $1.95 Typical High $5.25 | Professional | 52 · Reduced service | $1.95 | $1.95 | $5.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.78 Median $0.78 Typical High $2.04 | Professional | 53 · Discontinued | $0.78 | $0.78 | $2.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.59 Median $0.59 Typical High $1.55 | Professional | 55 · Aftercare only | $0.59 | $0.59 | $1.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.39 Median $0.39 Typical High $1.05 | Professional | 56 · Pre-op care only | $0.39 | $0.39 | $1.05 |
Where Missouri sits
The same service costs 3.2 times more in Hawaii than in Georgia. 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· 19th of 51
$7.08
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.