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 $2.29 Typical High $5.89 | Facility | None | $1.66 | $2.29 | $5.89 |
Aetna Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $4.27 | Professional | None | $1.78 | $1.78 | $4.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.78 Median $2.40 Typical High $4.68 | Facility | None | $1.78 | $2.40 | $4.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.66 Median $1.82 Typical High $4.27 | Professional | None | $1.66 | $1.82 | $4.27 |
Cigna Setting Facility Modifier None Typical Low $2.04 Median $3.09 Typical High $4.27 | Facility | None | $2.04 | $3.09 | $4.27 |
Cigna Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $1.78 | Professional | None | $1.78 | $1.78 | $1.78 |
Medica Setting Facility Modifier None Typical Low $0.81 Median $2.04 Typical High $2.95 | Facility | None | $0.81 | $2.04 | $2.95 |
Medica Setting Professional Modifier None Typical Low $1.41 Median $1.62 Typical High $1.91 | Professional | None | $1.41 | $1.62 | $1.91 |
United Setting Professional Modifier None Typical Low $1.66 Median $1.66 Typical High $2.09 | Professional | None | $1.66 | $1.66 | $2.09 |
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 $0.89 Median $0.89 Typical High $2.14 | Professional | 52 · Reduced service | $0.89 | $0.89 | $2.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.35 Median $0.35 Typical High $0.85 | Professional | 53 · Discontinued | $0.35 | $0.35 | $0.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.27 Median $0.27 Typical High $0.63 | Professional | 55 · Aftercare only | $0.27 | $0.27 | $0.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.18 Median $0.18 Typical High $0.42 | Professional | 56 · Pre-op care only | $0.18 | $0.18 | $0.42 |
Where Missouri sits
The same service costs 2.6 times more in Wyoming than in Hawaii. 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· 28th of 51
$1.78
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.