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 $2.24 Median $3.31 Typical High $4.57 | Facility | None | $2.24 | $3.31 | $4.57 |
Aetna Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $3.31 | Professional | None | $2.19 | $2.19 | $3.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.29 Median $2.95 Typical High $7.76 | Facility | None | $2.29 | $2.95 | $7.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.19 Median $2.40 Typical High $3.31 | Professional | None | $2.19 | $2.40 | $3.31 |
Cigna Setting Facility Modifier None Typical Low $2.51 Median $3.80 Typical High $5.13 | Facility | None | $2.51 | $3.80 | $5.13 |
Cigna Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | None | $2.19 | $2.19 | $2.19 |
Medica Setting Facility Modifier None Typical Low $2.04 Median $2.51 Typical High $3.55 | Facility | None | $2.04 | $2.51 | $3.55 |
Medica Setting Professional Modifier None Typical Low $2.19 Median $2.40 Typical High $2.75 | Professional | None | $2.19 | $2.40 | $2.75 |
United Setting Facility Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Facility | None | $2.19 | $2.19 | $2.19 |
United Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.63 | Professional | None | $2.19 | $2.19 | $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 $1.10 Median $1.10 Typical High $1.66 | Professional | 52 · Reduced service | $1.10 | $1.10 | $1.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.44 Median $0.44 Typical High $0.66 | Professional | 53 · Discontinued | $0.44 | $0.44 | $0.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.33 Median $0.33 Typical High $0.50 | Professional | 55 · Aftercare only | $0.33 | $0.33 | $0.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.22 Typical High $0.33 | Professional | 56 · Pre-op care only | $0.22 | $0.22 | $0.33 |
Where Missouri sits
The same service costs 1.9 times more in Alaska than in New York. 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· 17th of 51
$2.40
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.