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 $0.62 Median $0.62 Typical High $0.62 | Facility | None | $0.62 | $0.62 | $0.62 |
Aetna Setting Professional Modifier None Typical Low $0.62 Median $0.62 Typical High $0.62 | Professional | None | $0.62 | $0.62 | $0.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.29 Median $2.29 Typical High $8.91 | Facility | None | $2.29 | $2.29 | $8.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.59 Median $0.78 Typical High $0.78 | Professional | None | $0.59 | $0.78 | $0.78 |
Cigna Setting Facility Modifier None Typical Low $0.76 Median $1.10 Typical High $1.23 | Facility | None | $0.76 | $1.10 | $1.23 |
Cigna Setting Professional Modifier None Typical Low $0.66 Median $0.66 Typical High $0.66 | Professional | None | $0.66 | $0.66 | $0.66 |
Medica Setting Facility Modifier None Typical Low $0.62 Median $89.13 Typical High $100.00 | Facility | None | $0.62 | $89.13 | $100.00 |
Medica Setting Professional Modifier None Typical Low $0.62 Median $0.68 Typical High $0.71 | Professional | None | $0.62 | $0.68 | $0.71 |
United Setting Facility Modifier None Typical Low $2.14 Median $2.14 Typical High $2.14 | Facility | None | $2.14 | $2.14 | $2.14 |
United Setting Professional Modifier None Typical Low $0.54 Median $0.68 Typical High $0.76 | Professional | None | $0.54 | $0.68 | $0.76 |
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 $0.31 Median $0.31 Typical High $0.31 | Professional | 52 · Reduced service | $0.31 | $0.31 | $0.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | 53 · Discontinued | $0.12 | $0.12 | $0.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.06 |
Where Missouri sits
The same service costs 1.7 times more in South Carolina than in Hawaii. 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· 23rd of 51
$0.68
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.