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 $1.10 Median $1.62 Typical High $5.13 | Facility | None | $1.10 | $1.62 | $5.13 |
Aetna Setting Professional Modifier None Typical Low $1.10 Median $1.12 Typical High $5.13 | Professional | None | $1.10 | $1.12 | $5.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.10 Median $1.48 Typical High $2.88 | Facility | None | $1.10 | $1.48 | $2.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.10 Median $1.20 Typical High $5.13 | Professional | None | $1.10 | $1.20 | $5.13 |
Cigna Setting Facility Modifier None Typical Low $1.26 Median $1.91 Typical High $3.16 | Facility | None | $1.26 | $1.91 | $3.16 |
Cigna Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.23 | Professional | None | $1.10 | $1.10 | $1.23 |
Medica Setting Facility Modifier None Typical Low $1.17 Median $1.41 Typical High $5.01 | Facility | None | $1.17 | $1.41 | $5.01 |
Medica Setting Professional Modifier None Typical Low $0.51 Median $1.29 Typical High $1.41 | Professional | None | $0.51 | $1.29 | $1.41 |
United Setting Professional Modifier None Typical Low $0.44 Median $1.10 Typical High $1.26 | Professional | None | $0.44 | $1.10 | $1.26 |
5 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 $0.55 Median $0.56 Typical High $2.57 | Professional | 52 · Reduced service | $0.55 | $0.56 | $2.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.22 Median $0.22 Typical High $1.02 | Professional | 53 · Discontinued | $0.22 | $0.22 | $1.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.16 Median $0.17 Typical High $0.78 | Professional | 55 · Aftercare only | $0.16 | $0.17 | $0.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.51 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.51 |
Ambetter Setting Professional Modifier KO · Single-drug unit dose Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | KO · Single-drug unit dose | $1.10 | $1.10 | $1.10 |
Where Missouri sits
The same service costs 4.3 times more in Wyoming than in Delaware. 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· 16th of 51
$1.15
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.