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 $0.62 Median $1.74 Typical High $2.45 | Facility | None | $0.62 | $1.74 | $2.45 |
Aetna Setting Professional Modifier None Typical Low $0.60 Median $0.60 Typical High $2.40 | Professional | None | $0.60 | $0.60 | $2.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.60 Median $0.83 Typical High $1.62 | Facility | None | $0.60 | $0.83 | $1.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.60 Median $0.69 Typical High $2.40 | Professional | None | $0.60 | $0.69 | $2.40 |
Cigna Setting Facility Modifier None Typical Low $0.76 Median $1.41 Typical High $1.74 | Facility | None | $0.76 | $1.41 | $1.74 |
Cigna Setting Professional Modifier None Typical Low $0.60 Median $0.60 Typical High $0.60 | Professional | None | $0.60 | $0.60 | $0.60 |
Medica Setting Facility Modifier None Typical Low $0.62 Median $1.38 Typical High $2.19 | Facility | None | $0.62 | $1.38 | $2.19 |
Medica Setting Professional Modifier None Typical Low $0.59 Median $0.62 Typical High $0.76 | Professional | None | $0.59 | $0.62 | $0.76 |
United Setting Professional Modifier None Typical Low $0.62 Median $0.62 Typical High $1.15 | Professional | None | $0.62 | $0.62 | $1.15 |
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 $0.30 Median $0.30 Typical High $1.20 | Professional | 52 · Reduced service | $0.30 | $0.30 | $1.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.12 Median $0.12 Typical High $0.48 | Professional | 53 · Discontinued | $0.12 | $0.12 | $0.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $0.36 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.24 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.24 |
Where Missouri sits
The same service costs 3.4 times more in Wyoming than in Delaware. 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· 30th of 51
$0.65
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.