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 $1.74 Median $1.78 Typical High $2.29 | Facility | None | $1.74 | $1.78 | $2.29 |
Aetna Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $2.24 | Professional | None | $1.74 | $1.74 | $2.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.82 Median $2.34 Typical High $6.03 | Facility | None | $1.82 | $2.34 | $6.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.74 Median $1.91 Typical High $2.29 | Professional | None | $1.74 | $1.91 | $2.29 |
Cigna Setting Facility Modifier None Typical Low $2.00 Median $2.95 Typical High $4.07 | Facility | None | $2.00 | $2.95 | $4.07 |
Cigna Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | None | $1.74 | $1.74 | $1.74 |
Medica Setting Facility Modifier None Typical Low $1.48 Median $1.62 Typical High $2.29 | Facility | None | $1.48 | $1.62 | $2.29 |
Medica Setting Professional Modifier None Typical Low $1.41 Median $1.58 Typical High $1.82 | Professional | None | $1.41 | $1.58 | $1.82 |
United Setting Facility Modifier None Typical Low $1.74 Median $1.74 Typical High $1.74 | Facility | None | $1.74 | $1.74 | $1.74 |
United Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $2.00 | Professional | None | $1.74 | $1.74 | $2.00 |
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 $0.85 Median $0.85 Typical High $1.12 | Professional | 52 · Reduced service | $0.85 | $0.85 | $1.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.34 Median $0.34 Typical High $0.45 | Professional | 53 · Discontinued | $0.34 | $0.34 | $0.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.26 Median $0.26 Typical High $0.34 | Professional | 55 · Aftercare only | $0.26 | $0.26 | $0.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.17 Median $0.17 Typical High $0.22 | Professional | 56 · Pre-op care only | $0.17 | $0.17 | $0.22 |
Where Missouri sits
The same service costs 1.8 times more in Alaska than in Virginia. 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· 27th of 51
$1.74
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.