How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $6.31 Median $7.94 Typical High $10.96 | Facility | None | $6.31 | $7.94 | $10.96 |
Aetna Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $7.94 | Professional | None | $6.31 | $6.31 | $7.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $6.61 Median $8.91 Typical High $17.38 | Facility | None | $6.61 | $8.91 | $17.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.89 Median $7.94 Typical High $7.94 | Professional | None | $5.89 | $7.94 | $7.94 |
Cigna Setting Facility Modifier None Typical Low $7.59 Median $10.96 Typical High $12.59 | Facility | None | $7.59 | $10.96 | $12.59 |
Cigna Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
Medica Setting Facility Modifier None Typical Low $0.65 Median $6.61 Typical High $9.12 | Facility | None | $0.65 | $6.61 | $9.12 |
Medica Setting Professional Modifier None Typical Low $2.63 Median $6.61 Typical High $6.76 | Professional | None | $2.63 | $6.61 | $6.76 |
United Setting Professional Modifier None Typical Low $1.17 Median $6.61 Typical High $7.41 | Professional | None | $1.17 | $6.61 | $7.41 |
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 $3.16 Median $3.16 Typical High $3.98 | Professional | 52 · Reduced service | $3.16 | $3.16 | $3.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.26 Median $1.26 Typical High $1.58 | Professional | 53 · Discontinued | $1.26 | $1.26 | $1.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.95 Median $0.95 Typical High $1.17 | Professional | 55 · Aftercare only | $0.95 | $0.95 | $1.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.63 Median $0.63 Typical High $0.79 | Professional | 56 · Pre-op care only | $0.63 | $0.63 | $0.79 |
Where Missouri sits
The same service costs 15.5 times more in Alaska than in Hawaii. 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· 38th of 51
$6.61
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.