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 $0.69 Median $0.95 Typical High $1.58 | Facility | None | $0.69 | $0.95 | $1.58 |
Aetna Setting Professional Modifier None Typical Low $0.76 Median $0.78 Typical High $1.41 | Professional | None | $0.76 | $0.78 | $1.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.76 Median $1.00 Typical High $1.95 | Facility | None | $0.76 | $1.00 | $1.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.69 Median $0.76 Typical High $1.41 | Professional | None | $0.69 | $0.76 | $1.41 |
Cigna Setting Facility Modifier None Typical Low $0.85 Median $1.32 Typical High $1.78 | Facility | None | $0.85 | $1.32 | $1.78 |
Cigna Setting Professional Modifier None Typical Low $0.76 Median $0.76 Typical High $0.76 | Professional | None | $0.76 | $0.76 | $0.76 |
Medica Setting Facility Modifier None Typical Low $0.85 Median $1.55 Typical High $8.13 | Facility | None | $0.85 | $1.55 | $8.13 |
Medica Setting Professional Modifier None Typical Low $0.78 Median $0.89 Typical High $1.12 | Professional | None | $0.78 | $0.89 | $1.12 |
United Setting Professional Modifier None Typical Low $0.69 Median $0.69 Typical High $1.29 | Professional | None | $0.69 | $0.69 | $1.29 |
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 $0.38 Median $0.38 Typical High $0.71 | Professional | 52 · Reduced service | $0.38 | $0.38 | $0.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.15 Median $0.15 Typical High $0.28 | Professional | 53 · Discontinued | $0.15 | $0.15 | $0.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.11 Median $0.11 Typical High $0.21 | Professional | 55 · Aftercare only | $0.11 | $0.11 | $0.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.14 |
Where Missouri sits
The same service costs 5.2 times more in Vermont 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· 19th of 51
$0.85
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.