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 $1.26 Median $1.38 Typical High $1.74 | Facility | None | $1.26 | $1.38 | $1.74 |
Aetna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.51 | Professional | None | $1.26 | $1.26 | $1.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.35 Median $1.86 Typical High $4.90 | Facility | None | $1.35 | $1.86 | $4.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.26 Median $1.51 Typical High $1.74 | Professional | None | $1.26 | $1.51 | $1.74 |
Cigna Setting Facility Modifier None Typical Low $1.45 Median $2.14 Typical High $2.95 | Facility | None | $1.45 | $2.14 | $2.95 |
Cigna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | None | $1.26 | $1.26 | $1.26 |
Medica Setting Facility Modifier None Typical Low $1.00 Median $1.15 Typical High $1.78 | Facility | None | $1.00 | $1.15 | $1.78 |
Medica Setting Professional Modifier None Typical Low $0.95 Median $1.12 Typical High $1.32 | Professional | None | $0.95 | $1.12 | $1.32 |
United Setting Facility Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Facility | None | $1.26 | $1.26 | $1.26 |
United Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.58 | Professional | None | $1.38 | $1.38 | $1.58 |
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 $0.63 Median $0.63 Typical High $0.76 | Professional | 52 · Reduced service | $0.63 | $0.63 | $0.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.25 Median $0.25 Typical High $0.30 | Professional | 53 · Discontinued | $0.25 | $0.25 | $0.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.19 Median $0.19 Typical High $0.23 | Professional | 55 · Aftercare only | $0.19 | $0.19 | $0.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.13 Typical High $0.15 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $0.15 |
Where Missouri sits
The same service costs 1.7 times more in Arizona 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· 21st 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.