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 $9.55 Median $12.02 Typical High $16.60 | Facility | None | $9.55 | $12.02 | $16.60 |
Aetna Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $12.02 | Professional | None | $9.55 | $9.55 | $12.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.47 Median $11.22 Typical High $16.98 | Facility | None | $3.47 | $11.22 | $16.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.91 Median $12.02 Typical High $12.02 | Professional | None | $8.91 | $12.02 | $12.02 |
Cigna Setting Facility Modifier None Typical Low $11.48 Median $16.98 Typical High $19.05 | Facility | None | $11.48 | $16.98 | $19.05 |
Cigna Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | None | $10.23 | $10.23 | $10.23 |
Medica Setting Facility Modifier None Typical Low $10.23 Median $25.12 Typical High $100.00 | Facility | None | $10.23 | $25.12 | $100.00 |
Medica Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $12.88 | Professional | None | $10.72 | $10.72 | $12.88 |
United Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Facility | None | $3.89 | $3.89 | $3.89 |
United Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $12.59 | Professional | None | $10.00 | $10.00 | $12.59 |
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 $4.79 Median $4.79 Typical High $6.03 | Professional | 52 · Reduced service | $4.79 | $4.79 | $6.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.91 Median $1.91 Typical High $2.40 | Professional | 53 · Discontinued | $1.91 | $1.91 | $2.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.45 Median $1.45 Typical High $1.82 | Professional | 55 · Aftercare only | $1.45 | $1.45 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $0.95 Typical High $1.20 | Professional | 56 · Pre-op care only | $0.95 | $0.95 | $1.20 |
Where Missouri sits
The same service costs 9.1 times more in Alabama than in Virginia. 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
$10.72
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.