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 $1.35 Median $1.74 Typical High $5.01 | Facility | None | $1.35 | $1.74 | $5.01 |
Aetna Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $5.01 | Professional | None | $1.35 | $1.35 | $5.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.35 Median $1.82 Typical High $3.55 | Facility | None | $1.35 | $1.82 | $3.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.35 Median $1.48 Typical High $5.01 | Professional | None | $1.35 | $1.48 | $5.01 |
Cigna Setting Facility Modifier None Typical Low $1.55 Median $2.34 Typical High $3.89 | Facility | None | $1.55 | $2.34 | $3.89 |
Cigna Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $1.35 | Professional | None | $1.35 | $1.35 | $1.35 |
Medica Setting Facility Modifier None Typical Low $1.32 Median $2.40 Typical High $11.22 | Facility | None | $1.32 | $2.40 | $11.22 |
Medica Setting Professional Modifier None Typical Low $1.23 Median $1.38 Typical High $1.58 | Professional | None | $1.23 | $1.38 | $1.58 |
United Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $2.63 | Professional | None | $1.35 | $1.35 | $2.63 |
5 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 $0.68 Median $0.68 Typical High $2.51 | Professional | 52 · Reduced service | $0.68 | $0.68 | $2.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.27 Median $0.27 Typical High $1.00 | Professional | 53 · Discontinued | $0.27 | $0.27 | $1.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.20 Median $0.20 Typical High $0.76 | Professional | 55 · Aftercare only | $0.20 | $0.20 | $0.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.51 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.51 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $1.10 Median $1.10 Typical High $1.62 | Professional | JZ · No drug discarded | $1.10 | $1.10 | $1.62 |
Where Missouri sits
The same service costs 3.2 times more in Wyoming than in Maine. 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· 25th of 51
$1.38
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.