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 $6.92 Median $16.22 Typical High $16.22 | Facility | None | $6.92 | $16.22 | $16.22 |
Aetna Setting Professional Modifier None Typical Low $6.92 Median $9.77 Typical High $16.22 | Professional | None | $6.92 | $9.77 | $16.22 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.61 Median $9.12 Typical High $14.13 | Professional | None | $6.61 | $9.12 | $14.13 |
BCBS Kansas City Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $16.60 | Professional | None | $10.00 | $10.00 | $16.60 |
Cigna Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
Medica Setting Facility Modifier None Typical Low $8.71 Median $33.11 Typical High $93.33 | Facility | None | $8.71 | $33.11 | $93.33 |
Medica Setting Professional Modifier None Typical Low $5.75 Median $8.13 Typical High $218.78 | Professional | None | $5.75 | $8.13 | $218.78 |
United Setting Professional Modifier None Typical Low $5.37 Median $8.13 Typical High $13.18 | Professional | None | $5.37 | $8.13 | $13.18 |
5 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 $3.47 Median $4.90 Typical High $8.13 | Professional | 52 · Reduced service | $3.47 | $4.90 | $8.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.38 Median $2.00 Typical High $3.24 | Professional | 53 · Discontinued | $1.38 | $2.00 | $3.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $5.25 Median $7.41 Typical High $12.02 | Professional | 54 · Surgery only | $5.25 | $7.41 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.05 Median $1.48 Typical High $2.45 | Professional | 55 · Aftercare only | $1.05 | $1.48 | $2.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.69 Median $1.00 Typical High $1.62 | Professional | 56 · Pre-op care only | $0.69 | $1.00 | $1.62 |
Where Missouri sits
The same service costs 3.2 times more in Rhode Island than in New York. 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· 36th of 51
$9.12
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.