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 $1.66 Median $2.34 Typical High $3.47 | Facility | None | $1.66 | $2.34 | $3.47 |
Aetna Setting Professional Modifier None Typical Low $1.91 Median $2.29 Typical High $2.95 | Professional | None | $1.91 | $2.29 | $2.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.24 Median $2.82 Typical High $6.03 | Facility | None | $2.24 | $2.82 | $6.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.66 Median $2.14 Typical High $2.29 | Professional | None | $1.66 | $2.14 | $2.29 |
Cigna Setting Facility Modifier None Typical Low $2.57 Median $3.98 Typical High $5.37 | Facility | None | $2.57 | $3.98 | $5.37 |
Cigna Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | None | $2.29 | $2.29 | $2.29 |
Medica Setting Facility Modifier None Typical Low $1.02 Median $1.70 Typical High $19.05 | Facility | None | $1.02 | $1.70 | $19.05 |
Medica Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.66 | Professional | None | $1.32 | $1.32 | $1.66 |
United Setting Professional Modifier None Typical Low $1.66 Median $1.66 Typical High $2.57 | Professional | None | $1.66 | $1.66 | $2.57 |
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 $0.87 Median $1.15 Typical High $1.20 | Professional | 52 · Reduced service | $0.87 | $1.15 | $1.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.35 Median $0.46 Typical High $0.47 | Professional | 53 · Discontinued | $0.35 | $0.46 | $0.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.26 Median $0.35 Typical High $0.36 | Professional | 55 · Aftercare only | $0.26 | $0.35 | $0.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.17 Median $0.23 Typical High $0.24 | Professional | 56 · Pre-op care only | $0.17 | $0.23 | $0.24 |
Where Missouri sits
The same service costs 3.8 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· 40th of 51
$2.14
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.