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 $3.55 Median $4.57 Typical High $6.31 | Facility | None | $3.55 | $4.57 | $6.31 |
Aetna Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $4.57 | Professional | None | $3.47 | $3.47 | $4.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.47 Median $4.68 Typical High $11.48 | Facility | None | $3.47 | $4.68 | $11.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.24 Median $3.55 Typical High $4.57 | Professional | None | $3.24 | $3.55 | $4.57 |
Cigna Setting Facility Modifier None Typical Low $3.98 Median $5.89 Typical High $8.13 | Facility | None | $3.98 | $5.89 | $8.13 |
Cigna Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
Medica Setting Facility Modifier None Typical Low $3.09 Median $3.31 Typical High $4.79 | Facility | None | $3.09 | $3.31 | $4.79 |
Medica Setting Professional Modifier None Typical Low $2.95 Median $3.24 Typical High $3.80 | Professional | None | $2.95 | $3.24 | $3.80 |
United Setting Facility Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Facility | None | $3.47 | $3.47 | $3.47 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.72 | Professional | None | $3.24 | $3.24 | $3.72 |
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 $1.74 Median $1.74 Typical High $2.29 | Professional | 52 · Reduced service | $1.74 | $1.74 | $2.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.69 Median $0.69 Typical High $0.91 | Professional | 53 · Discontinued | $0.69 | $0.69 | $0.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.52 Typical High $0.69 | Professional | 55 · Aftercare only | $0.52 | $0.52 | $0.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.35 Typical High $0.46 | Professional | 56 · Pre-op care only | $0.35 | $0.35 | $0.46 |
Where Missouri sits
The same service costs 2.1 times more in Alaska than in Oklahoma. 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· 36th of 51
$3.47
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.