How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $3.39 Median $4.27 Typical High $5.89 | Facility | None | $3.39 | $4.27 | $5.89 |
Aetna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $4.27 | Professional | None | $3.39 | $3.39 | $4.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.55 Median $4.79 Typical High $9.33 | Facility | None | $3.55 | $4.79 | $9.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.16 Median $4.27 Typical High $4.27 | Professional | None | $3.16 | $4.27 | $4.27 |
Cigna Setting Facility Modifier None Typical Low $4.07 Median $5.89 Typical High $6.76 | Facility | None | $4.07 | $5.89 | $6.76 |
Cigna Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | None | $3.63 | $3.63 | $3.63 |
Medica Setting Facility Modifier None Typical Low $3.24 Median $3.72 Typical High $4.27 | Facility | None | $3.24 | $3.72 | $4.27 |
Medica Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.89 | Professional | None | $3.39 | $3.39 | $3.89 |
United Setting Professional Modifier None Typical Low $3.39 Median $3.55 Typical High $4.07 | Professional | None | $3.39 | $3.55 | $4.07 |
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 $1.70 Median $1.70 Typical High $2.14 | Professional | 52 · Reduced service | $1.70 | $1.70 | $2.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.68 Median $0.68 Typical High $0.85 | Professional | 53 · Discontinued | $0.68 | $0.68 | $0.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.51 Median $0.51 Typical High $0.63 | Professional | 55 · Aftercare only | $0.51 | $0.51 | $0.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.34 Median $0.34 Typical High $0.42 | Professional | 56 · Pre-op care only | $0.34 | $0.34 | $0.42 |
Where Missouri sits
The same service costs 2.0 times more in Alaska 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· 43rd of 51
$3.55
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.