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 $0.93 Median $2.14 Typical High $2.95 | Facility | None | $0.93 | $2.14 | $2.95 |
Aetna Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $2.40 | Professional | None | $0.89 | $0.89 | $2.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.89 Median $1.38 Typical High $2.51 | Facility | None | $0.89 | $1.38 | $2.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.89 Median $1.12 Typical High $2.40 | Professional | None | $0.89 | $1.12 | $2.40 |
Cigna Setting Facility Modifier None Typical Low $1.05 Median $1.58 Typical High $2.40 | Facility | None | $1.05 | $1.58 | $2.40 |
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 $0.91 Median $2.14 Typical High $100.00 | Facility | None | $0.91 | $2.14 | $100.00 |
Medica Setting Professional Modifier None Typical Low $0.68 Median $0.68 Typical High $0.81 | Professional | None | $0.68 | $0.68 | $0.81 |
United Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.26 | Professional | None | $1.02 | $1.02 | $1.26 |
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 $0.14 Typical High $0.36 | Professional | 55 · Aftercare only | $0.14 | $0.14 | $0.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.09 Typical High $0.24 | Professional | 56 · Pre-op care only | $0.09 | $0.09 | $0.24 |
Where Missouri 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.
Missouri· 26th of 51
$1.02
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.