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 $0.21 Median $0.27 Typical High $0.68 | Facility | None | $0.21 | $0.27 | $0.68 |
Aetna Setting Professional Modifier None Typical Low $0.20 Median $0.21 Typical High $0.48 | Professional | None | $0.20 | $0.21 | $0.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.20 Median $0.28 Typical High $0.55 | Facility | None | $0.20 | $0.28 | $0.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.20 Median $0.23 Typical High $0.48 | Professional | None | $0.20 | $0.23 | $0.48 |
Cigna Setting Facility Modifier None Typical Low $0.23 Median $0.35 Typical High $0.48 | Facility | None | $0.23 | $0.35 | $0.48 |
Cigna Setting Professional Modifier None Typical Low $0.20 Median $0.20 Typical High $0.23 | Professional | None | $0.20 | $0.20 | $0.23 |
Medica Setting Facility Modifier None Typical Low $0.15 Median $0.24 Typical High $0.48 | Facility | None | $0.15 | $0.24 | $0.48 |
Medica Setting Professional Modifier None Typical Low $0.08 Median $0.20 Typical High $0.24 | Professional | None | $0.08 | $0.20 | $0.24 |
United Setting Professional Modifier None Typical Low $0.08 Median $0.21 Typical High $0.26 | Professional | None | $0.08 | $0.21 | $0.26 |
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 $0.10 Median $0.11 Typical High $0.24 | Professional | 52 · Reduced service | $0.10 | $0.11 | $0.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.04 Median $0.04 Typical High $0.10 | Professional | 53 · Discontinued | $0.04 | $0.04 | $0.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.03 Median $0.03 Typical High $0.07 | Professional | 55 · Aftercare only | $0.03 | $0.03 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.05 |
Where Missouri sits
The same service costs 2.3 times more in Oklahoma than in Florida. 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· 11th of 51
$0.21
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.