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 $3.47 Median $8.13 Typical High $8.13 | Facility | None | $3.47 | $8.13 | $8.13 |
Aetna Setting Professional Modifier None Typical Low $3.47 Median $4.90 Typical High $8.13 | Professional | None | $3.47 | $4.90 | $8.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.39 Median $4.57 Typical High $6.61 | Professional | None | $3.39 | $4.57 | $6.61 |
BCBS Kansas City Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $8.32 | Professional | None | $4.90 | $4.90 | $8.32 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | None | $3.39 | $3.39 | $3.39 |
Medica Setting Facility Modifier None Typical Low $4.27 Median $16.60 Typical High $89.13 | Facility | None | $4.27 | $16.60 | $89.13 |
Medica Setting Professional Modifier None Typical Low $2.88 Median $4.07 Typical High $107.15 | Professional | None | $2.88 | $4.07 | $107.15 |
United Setting Professional Modifier None Typical Low $2.69 Median $4.07 Typical High $6.61 | Professional | None | $2.69 | $4.07 | $6.61 |
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 $1.74 Median $2.45 Typical High $4.07 | Professional | 52 · Reduced service | $1.74 | $2.45 | $4.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.69 Median $1.00 Typical High $1.62 | Professional | 53 · Discontinued | $0.69 | $1.00 | $1.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.57 Median $3.72 Typical High $6.03 | Professional | 54 · Surgery only | $2.57 | $3.72 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.74 Typical High $1.20 | Professional | 55 · Aftercare only | $0.52 | $0.74 | $1.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.49 Typical High $0.81 | Professional | 56 · Pre-op care only | $0.35 | $0.49 | $0.81 |
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· 35th of 51
$4.57
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.