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 $7.24 Median $25.12 Typical High $35.48 | Facility | None | $7.24 | $25.12 | $35.48 |
Aetna Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $29.51 | Professional | None | $7.76 | $7.76 | $29.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $7.76 Median $10.47 Typical High $20.42 | Facility | None | $7.76 | $10.47 | $20.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.24 Median $7.94 Typical High $29.51 | Professional | None | $7.24 | $7.94 | $29.51 |
Cigna Setting Facility Modifier None Typical Low $8.91 Median $13.49 Typical High $22.39 | Facility | None | $8.91 | $13.49 | $22.39 |
Cigna Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | None | $7.76 | $7.76 | $7.76 |
Medica Setting Facility Modifier None Typical Low $8.13 Median $17.78 Typical High $75.86 | Facility | None | $8.13 | $17.78 | $75.86 |
Medica Setting Professional Modifier None Typical Low $6.92 Median $7.76 Typical High $8.91 | Professional | None | $6.92 | $7.76 | $8.91 |
United Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $8.91 | Professional | None | $7.24 | $7.24 | $8.91 |
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 $3.89 Median $3.89 Typical High $14.79 | Professional | 52 · Reduced service | $3.89 | $3.89 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.55 Median $1.55 Typical High $5.89 | Professional | 53 · Discontinued | $1.55 | $1.55 | $5.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.15 Median $1.15 Typical High $4.37 | Professional | 55 · Aftercare only | $1.15 | $1.15 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.78 Median $0.78 Typical High $2.95 | Professional | 56 · Pre-op care only | $0.78 | $0.78 | $2.95 |
Where Missouri sits
The same service costs 3.5 times more in Wyoming than in Maryland. 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· 22nd of 51
$7.76
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.