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 $5.62 Median $6.92 Typical High $9.55 | Facility | None | $5.62 | $6.92 | $9.55 |
Aetna Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $6.92 | Professional | None | $5.50 | $5.50 | $6.92 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.62 Median $7.41 Typical High $18.62 | Facility | None | $5.62 | $7.41 | $18.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.37 Median $5.89 Typical High $6.92 | Professional | None | $5.37 | $5.89 | $6.92 |
Cigna Setting Facility Modifier None Typical Low $6.31 Median $9.55 Typical High $12.88 | Facility | None | $6.31 | $9.55 | $12.88 |
Cigna Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
Medica Setting Facility Modifier None Typical Low $5.01 Median $5.50 Typical High $7.24 | Facility | None | $5.01 | $5.50 | $7.24 |
Medica Setting Professional Modifier None Typical Low $4.79 Median $5.37 Typical High $6.17 | Professional | None | $4.79 | $5.37 | $6.17 |
United Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Facility | None | $5.50 | $5.50 | $5.50 |
United Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $6.17 | Professional | None | $5.37 | $5.37 | $6.17 |
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 $2.75 Median $2.75 Typical High $3.47 | Professional | 52 · Reduced service | $2.75 | $2.75 | $3.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.10 Median $1.10 Typical High $1.38 | Professional | 53 · Discontinued | $1.10 | $1.10 | $1.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.83 Median $0.83 Typical High $1.05 | Professional | 55 · Aftercare only | $0.83 | $0.83 | $1.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.55 Median $0.55 Typical High $0.69 | Professional | 56 · Pre-op care only | $0.55 | $0.55 | $0.69 |
Where Missouri sits
The same service costs 1.7 times more in Alaska than in Nebraska. 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· 23rd of 51
$5.50
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.