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 $7.76 Median $50.12 Typical High $69.18 | Facility | None | $7.76 | $50.12 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $12.30 Typical High $52.48 | Professional | None | $8.13 | $12.30 | $52.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $10.47 Median $14.13 Typical High $32.36 | Facility | None | $10.47 | $14.13 | $32.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.76 Median $12.30 Typical High $57.54 | Professional | None | $7.76 | $12.30 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $14.13 Median $21.38 Typical High $35.48 | Facility | None | $14.13 | $21.38 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | None | $12.30 | $12.30 | $12.30 |
Medica Setting Facility Modifier None Typical Low $15.49 Median $54.95 Typical High $120.23 | Facility | None | $15.49 | $54.95 | $120.23 |
Medica Setting Professional Modifier None Typical Low $5.75 Median $14.45 Typical High $15.85 | Professional | None | $5.75 | $14.45 | $15.85 |
United Setting Professional Modifier None Typical Low $3.09 Median $7.76 Typical High $9.77 | Professional | None | $3.09 | $7.76 | $9.77 |
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 $4.07 Median $6.17 Typical High $28.84 | Professional | 52 · Reduced service | $4.07 | $6.17 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $2.45 Typical High $11.48 | Professional | 53 · Discontinued | $1.62 | $2.45 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.86 Typical High $8.71 | Professional | 55 · Aftercare only | $1.23 | $1.86 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $1.23 Typical High $5.75 | Professional | 56 · Pre-op care only | $0.81 | $1.23 | $5.75 |
Where Missouri sits
The same service costs 6.3 times more in Wyoming than in Rhode Island. 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· 14th of 51
$12.30
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.