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 $0.56 Median $0.72 Typical High $2.75 | Facility | None | $0.56 | $0.72 | $2.75 |
Aetna Setting Professional Modifier None Typical Low $0.56 Median $0.59 Typical High $2.29 | Professional | None | $0.56 | $0.59 | $2.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.56 Median $0.87 Typical High $1.58 | Facility | None | $0.56 | $0.87 | $1.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.56 Median $0.81 Typical High $2.14 | Professional | None | $0.56 | $0.81 | $2.14 |
BCBS Kansas City Setting Professional Modifier None Typical Low $0.63 Median $0.63 Typical High $4.57 | Professional | None | $0.63 | $0.63 | $4.57 |
Cigna Setting Facility Modifier None Typical Low $0.69 Median $1.32 Typical High $1.66 | Facility | None | $0.69 | $1.32 | $1.66 |
Cigna Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | None | $0.55 | $0.55 | $0.55 |
Medica Setting Facility Modifier None Typical Low $0.45 Median $1.38 Typical High $4.57 | Facility | None | $0.45 | $1.38 | $4.57 |
Medica Setting Professional Modifier None Typical Low $0.41 Median $0.48 Typical High $0.54 | Professional | None | $0.41 | $0.48 | $0.54 |
United Setting Professional Modifier None Typical Low $0.59 Median $0.68 Typical High $0.78 | Professional | None | $0.59 | $0.68 | $0.78 |
2 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 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $0.34 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.23 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.23 |
Where Missouri sits
The same service costs 1.9 times more in Wyoming 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· 17th of 51
$0.62
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.