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 $11.22 Median $40.74 Typical High $57.54 | Facility | None | $11.22 | $40.74 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $10.96 Median $11.22 Typical High $47.86 | Professional | None | $10.96 | $11.22 | $47.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $11.75 Median $15.14 Typical High $39.81 | Facility | None | $11.75 | $15.14 | $39.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.96 Median $12.30 Typical High $47.86 | Professional | None | $10.96 | $12.30 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $12.59 Median $19.50 Typical High $32.36 | Facility | None | $12.59 | $19.50 | $32.36 |
Cigna Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | None | $10.96 | $10.96 | $10.96 |
Medica Setting Facility Modifier None Typical Low $10.96 Median $40.74 Typical High $95.50 | Facility | None | $10.96 | $40.74 | $95.50 |
Medica Setting Professional Modifier None Typical Low $10.00 Median $10.96 Typical High $12.88 | Professional | None | $10.00 | $10.96 | $12.88 |
United Setting Facility Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Facility | None | $10.96 | $10.96 | $10.96 |
United Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $14.13 | Professional | None | $11.22 | $11.22 | $14.13 |
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 $5.50 Median $5.50 Typical High $23.99 | Professional | 52 · Reduced service | $5.50 | $5.50 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.19 Median $2.19 Typical High $9.55 | Professional | 53 · Discontinued | $2.19 | $2.19 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.66 Median $1.66 Typical High $7.24 | Professional | 55 · Aftercare only | $1.66 | $1.66 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.10 Median $1.10 Typical High $4.79 | Professional | 56 · Pre-op care only | $1.10 | $1.10 | $4.79 |
Where Missouri sits
The same service costs 3.7 times more in Wyoming 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· 31st of 51
$11.48
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.