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 $10.72 Median $10.72 Typical High $10.72 | Facility | None | $10.72 | $10.72 | $10.72 |
Aetna Setting Professional Modifier None Typical Low $1.51 Median $9.77 Typical High $10.72 | Professional | None | $1.51 | $9.77 | $10.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.19 Median $3.31 Typical High $7.08 | Professional | None | $2.19 | $3.31 | $7.08 |
Cigna Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | None | $6.46 | $6.46 | $6.46 |
Medica Setting Facility Modifier None Typical Low $3.39 Median $20.42 Typical High $89.13 | Facility | None | $3.39 | $20.42 | $89.13 |
Medica Setting Professional Modifier None Typical Low $9.55 Median $14.45 Typical High $23.99 | Professional | None | $9.55 | $14.45 | $23.99 |
United Setting Professional Modifier None Typical Low $9.55 Median $15.14 Typical High $26.30 | Professional | None | $9.55 | $15.14 | $26.30 |
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 $4.68 Median $4.90 Typical High $6.03 | Professional | 52 · Reduced service | $4.68 | $4.90 | $6.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.91 Median $1.95 Typical High $2.40 | Professional | 53 · Discontinued | $1.91 | $1.95 | $2.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.41 Median $1.45 Typical High $1.82 | Professional | 55 · Aftercare only | $1.41 | $1.45 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.93 Median $0.98 Typical High $1.20 | Professional | 56 · Pre-op care only | $0.93 | $0.98 | $1.20 |
Where Missouri sits
The same service costs 25.1 times more in Wyoming than in New Jersey. 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· 44th of 51
$6.46
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.