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 $2.14 Median $3.47 Typical High $5.01 | Facility | None | $2.14 | $3.47 | $5.01 |
Aetna Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $3.47 | Professional | None | $2.14 | $2.14 | $3.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.24 Median $2.88 Typical High $7.41 | Facility | None | $2.24 | $2.88 | $7.41 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.14 Median $2.34 Typical High $3.63 | Professional | None | $2.14 | $2.34 | $3.63 |
Cigna Setting Facility Modifier None Typical Low $2.45 Median $3.72 Typical High $5.13 | Facility | None | $2.45 | $3.72 | $5.13 |
Cigna Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | None | $2.14 | $2.14 | $2.14 |
Medica Setting Facility Modifier None Typical Low $1.78 Median $2.04 Typical High $3.31 | Facility | None | $1.78 | $2.04 | $3.31 |
Medica Setting Professional Modifier None Typical Low $1.82 Median $2.00 Typical High $2.29 | Professional | None | $1.82 | $2.00 | $2.29 |
United Setting Facility Modifier None Typical Low $2.14 Median $2.14 Typical High $2.14 | Facility | None | $2.14 | $2.14 | $2.14 |
United Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.63 | Professional | None | $2.14 | $2.14 | $2.63 |
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 $1.07 Median $1.07 Typical High $1.74 | Professional | 52 · Reduced service | $1.07 | $1.07 | $1.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.43 Median $0.43 Typical High $0.71 | Professional | 53 · Discontinued | $0.43 | $0.43 | $0.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.32 Median $0.32 Typical High $0.52 | Professional | 55 · Aftercare only | $0.32 | $0.32 | $0.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.22 Typical High $0.35 | Professional | 56 · Pre-op care only | $0.22 | $0.22 | $0.35 |
Where Missouri sits
The same service costs 1.6 times more in Arizona than in Mississippi. 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· 36th of 51
$2.14
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.