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 $10.96 Median $10.96 Typical High $10.96 | Facility | None | $10.96 | $10.96 | $10.96 |
Aetna Setting Professional Modifier None Typical Low $5.75 Median $10.96 Typical High $10.96 | Professional | None | $5.75 | $10.96 | $10.96 |
Ambetter Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $21.38 | Professional | None | $9.12 | $9.12 | $21.38 |
BCBS Setting Facility Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Facility | None | $8.51 | $8.51 | $8.51 |
BCBS Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | None | $8.71 | $8.71 | $8.71 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Facility | None | $7.08 | $7.08 | $7.08 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $7.08 | Professional | None | $5.25 | $5.25 | $7.08 |
United Setting Facility Modifier None Typical Low $6.31 Median $7.94 Typical High $18.20 | Facility | None | $6.31 | $7.94 | $18.20 |
United Setting Professional Modifier None Typical Low $3.72 Median $5.25 Typical High $8.32 | Professional | None | $3.72 | $5.25 | $8.32 |
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 $3.02 Median $5.50 Typical High $5.50 | Professional | 52 · Reduced service | $3.02 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.23 Median $2.19 Typical High $2.19 | Professional | 53 · Discontinued | $1.23 | $2.19 | $2.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.91 Median $1.66 Typical High $1.66 | Professional | 55 · Aftercare only | $0.91 | $1.66 | $1.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.62 Median $1.12 Typical High $1.12 | Professional | 56 · Pre-op care only | $0.62 | $1.12 | $1.12 |
Where Mississippi sits
The same service costs 3.5 times more in Montana than in Kansas. 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.
Mississippi· 19th of 51
$8.32
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.