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 $5.62 Median $5.62 Typical High $5.62 | Facility | None | $5.62 | $5.62 | $5.62 |
Aetna Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.02 Median $0.02 Typical High $0.03 | Facility | None | $0.02 | $0.02 | $0.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.25 Median $7.08 Typical High $7.08 | Professional | None | $5.25 | $7.08 | $7.08 |
Cigna Setting Facility Modifier None Typical Low $6.92 Median $10.23 Typical High $11.48 | Facility | None | $6.92 | $10.23 | $11.48 |
Cigna Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | None | $6.17 | $6.17 | $6.17 |
Medica Setting Facility Modifier None Typical Low $4.07 Median $5.75 Typical High $11.48 | Facility | None | $4.07 | $5.75 | $11.48 |
Medica Setting Professional Modifier None Typical Low $12.02 Median $12.30 Typical High $14.45 | Professional | None | $12.02 | $12.30 | $14.45 |
United Setting Professional Modifier None Typical Low $12.02 Median $12.30 Typical High $14.45 | Professional | None | $12.02 | $12.30 | $14.45 |
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 $2.82 Median $2.82 Typical High $2.82 | Professional | 52 · Reduced service | $2.82 | $2.82 | $2.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | 53 · Discontinued | $1.12 | $1.12 | $1.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.83 Median $0.83 Typical High $0.83 | Professional | 55 · Aftercare only | $0.83 | $0.83 | $0.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.56 Typical High $0.56 | Professional | 56 · Pre-op care only | $0.56 | $0.56 | $0.56 |
Where Missouri sits
The same service costs 2.1 times more in Iowa 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· 23rd 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.