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 $4.90 Median $5.50 Typical High $19.50 | Facility | None | $4.90 | $5.50 | $19.50 |
Aetna Setting Professional Modifier None Typical Low $5.25 Median $5.50 Typical High $19.50 | Professional | None | $5.25 | $5.50 | $19.50 |
Ambetter Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.25 Median $7.08 Typical High $13.80 | Facility | None | $5.25 | $7.08 | $13.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.01 Median $6.17 Typical High $19.50 | Professional | None | $5.01 | $6.17 | $19.50 |
BCBS Kansas City Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | None | $5.75 | $5.75 | $5.75 |
Cigna Setting Facility Modifier None Typical Low $6.61 Median $12.59 Typical High $15.49 | Facility | None | $6.61 | $12.59 | $15.49 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
Medica Setting Facility Modifier None Typical Low $6.92 Median $8.51 Typical High $16.98 | Facility | None | $6.92 | $8.51 | $16.98 |
Medica Setting Professional Modifier None Typical Low $6.31 Median $7.41 Typical High $8.32 | Professional | None | $6.31 | $7.41 | $8.32 |
United Setting Professional Modifier None Typical Low $4.47 Median $5.25 Typical High $5.89 | Professional | None | $4.47 | $5.25 | $5.89 |
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 $2.63 Median $2.69 Typical High $9.77 | Professional | 52 · Reduced service | $2.63 | $2.69 | $9.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $1.10 Typical High $3.89 | Professional | 53 · Discontinued | $1.07 | $1.10 | $3.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.79 Median $0.81 Typical High $2.95 | Professional | 55 · Aftercare only | $0.79 | $0.81 | $2.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.54 Typical High $1.95 | Professional | 56 · Pre-op care only | $0.52 | $0.54 | $1.95 |
Where Missouri sits
The same service costs 1.9 times more in Wyoming than in Colorado. 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· 15th of 51
$5.50
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.