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 $8.71 Median $10.96 Typical High $13.49 | Facility | None | $8.71 | $10.96 | $13.49 |
Aetna Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $10.96 | Professional | None | $8.71 | $8.71 | $10.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $9.12 Median $12.30 Typical High $23.99 | Facility | None | $9.12 | $12.30 | $23.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.32 Median $10.96 Typical High $10.96 | Professional | None | $8.32 | $10.96 | $10.96 |
BCBS Kansas City Setting Professional Modifier None Typical Low $12.02 Median $20.89 Typical High $20.89 | Professional | None | $12.02 | $20.89 | $20.89 |
Cigna Setting Facility Modifier None Typical Low $11.75 Median $22.39 Typical High $23.99 | Facility | None | $11.75 | $22.39 | $23.99 |
Cigna Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
Medica Setting Facility Modifier None Typical Low $8.32 Median $21.88 Typical High $100.00 | Facility | None | $8.32 | $21.88 | $100.00 |
Medica Setting Professional Modifier None Typical Low $8.32 Median $9.12 Typical High $9.33 | Professional | None | $8.32 | $9.12 | $9.33 |
United Setting Professional Modifier None Typical Low $8.32 Median $9.12 Typical High $9.33 | Professional | None | $8.32 | $9.12 | $9.33 |
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 $4.37 Median $4.37 Typical High $5.50 | Professional | 52 · Reduced service | $4.37 | $4.37 | $5.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.78 Median $1.78 Typical High $2.19 | Professional | 53 · Discontinued | $1.78 | $1.78 | $2.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.32 Median $1.32 Typical High $1.66 | Professional | 55 · Aftercare only | $1.32 | $1.32 | $1.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.87 Median $0.87 Typical High $1.10 | Professional | 56 · Pre-op care only | $0.87 | $0.87 | $1.10 |
Where Missouri sits
The same service costs 1.8 times more in Alaska than in Montana. 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· 33rd of 51
$9.12
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.