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 $5.75 Median $5.89 Typical High $9.12 | Facility | None | $5.75 | $5.89 | $9.12 |
Aetna Setting Professional Modifier None Typical Low $5.75 Median $5.89 Typical High $6.76 | Professional | None | $5.75 | $5.89 | $6.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.89 Median $7.76 Typical High $19.95 | Facility | None | $5.89 | $7.76 | $19.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.90 Median $6.46 Typical High $6.61 | Professional | None | $4.90 | $6.46 | $6.61 |
BCBS Kansas City Setting Professional Modifier None Typical Low $6.31 Median $10.96 Typical High $10.96 | Professional | None | $6.31 | $10.96 | $10.96 |
Cigna Setting Facility Modifier None Typical Low $6.92 Median $13.18 Typical High $14.13 | Facility | None | $6.92 | $13.18 | $14.13 |
Cigna Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
Medica Setting Facility Modifier None Typical Low $5.75 Median $5.89 Typical High $7.41 | Facility | None | $5.75 | $5.89 | $7.41 |
Medica Setting Professional Modifier None Typical Low $5.75 Median $25.12 Typical High $25.12 | Professional | None | $5.75 | $25.12 | $25.12 |
United Setting Facility Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Facility | None | $5.75 | $5.75 | $5.75 |
United Setting Professional Modifier None Typical Low $5.13 Median $6.03 Typical High $6.46 | Professional | None | $5.13 | $6.03 | $6.46 |
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 $2.88 Median $2.95 Typical High $3.39 | Professional | 52 · Reduced service | $2.88 | $2.95 | $3.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.15 Median $1.17 Typical High $1.35 | Professional | 53 · Discontinued | $1.15 | $1.17 | $1.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.85 Median $0.89 Typical High $1.02 | Professional | 55 · Aftercare only | $0.85 | $0.89 | $1.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.59 Typical High $0.68 | Professional | 56 · Pre-op care only | $0.56 | $0.59 | $0.68 |
Where Missouri sits
The same service costs 1.5 times more in Alaska than in Pennsylvania. 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· 10th of 51
$6.03
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.