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 $4.27 Median $4.68 Typical High $15.85 | Facility | None | $4.27 | $4.68 | $15.85 |
Aetna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $11.48 | Professional | None | $4.27 | $4.27 | $11.48 |
Ambetter Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.27 Median $6.31 Typical High $11.75 | Facility | None | $4.27 | $6.31 | $11.75 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.27 Median $5.25 Typical High $11.48 | Professional | None | $4.27 | $5.25 | $11.48 |
Cigna Setting Facility Modifier None Typical Low $4.90 Median $7.41 Typical High $11.48 | Facility | None | $4.90 | $7.41 | $11.48 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Medica Setting Facility Modifier None Typical Low $5.62 Median $11.48 Typical High $16.22 | Facility | None | $5.62 | $11.48 | $16.22 |
Medica Setting Professional Modifier None Typical Low $5.25 Median $5.62 Typical High $6.46 | Professional | None | $5.25 | $5.62 | $6.46 |
United Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $5.89 | Professional | None | $4.68 | $4.68 | $5.89 |
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 $2.14 Median $2.14 Typical High $5.75 | Professional | 52 · Reduced service | $2.14 | $2.14 | $5.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.85 Median $0.85 Typical High $2.29 | Professional | 53 · Discontinued | $0.85 | $0.85 | $2.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.63 Median $0.63 Typical High $1.70 | Professional | 55 · Aftercare only | $0.63 | $0.63 | $1.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.42 Median $0.42 Typical High $1.12 | Professional | 56 · Pre-op care only | $0.42 | $0.42 | $1.12 |
Where Missouri sits
The same service costs 3.4 times more in Texas 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· 13th of 51
$5.13
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.