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 $1.20 Median $2.14 Typical High $2.14 | Facility | None | $1.20 | $2.14 | $2.14 |
Aetna Setting Professional Modifier None Typical Low $0.89 Median $1.23 Typical High $2.14 | Professional | None | $0.89 | $1.23 | $2.14 |
BCBS Setting Facility Modifier None Typical Low $1.00 Median $1.05 Typical High $1.05 | Facility | None | $1.00 | $1.05 | $1.05 |
BCBS Setting Professional Modifier None Typical Low $0.93 Median $0.93 Typical High $0.93 | Professional | None | $0.93 | $0.93 | $0.93 |
Cigna Setting Facility Modifier None Typical Low $0.91 Median $2.63 Typical High $3.55 | Facility | None | $0.91 | $2.63 | $3.55 |
Cigna Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $0.89 | Professional | None | $0.89 | $0.89 | $0.89 |
Medica Setting Facility Modifier None Typical Low $0.79 Median $2.14 Typical High $2.14 | Facility | None | $0.79 | $2.14 | $2.14 |
Medica Setting Professional Modifier None Typical Low $0.68 Median $0.68 Typical High $1.12 | Professional | None | $0.68 | $0.68 | $1.12 |
United Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $2.40 | Professional | None | $1.02 | $1.02 | $2.40 |
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 $0.14 Median $0.18 Typical High $0.32 | Professional | 55 · Aftercare only | $0.14 | $0.18 | $0.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.12 Typical High $0.21 | Professional | 56 · Pre-op care only | $0.09 | $0.12 | $0.21 |
Where Kansas sits
The same service costs 2.3 times more in South Carolina 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.
Kansas· 41st of 51
$1.00
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.