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 $2.29 Median $5.37 Typical High $5.37 | Facility | None | $2.29 | $5.37 | $5.37 |
Aetna Setting Professional Modifier None Typical Low $2.29 Median $3.31 Typical High $5.37 | Professional | None | $2.29 | $3.31 | $5.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.24 Median $3.09 Typical High $4.68 | Professional | None | $2.24 | $3.09 | $4.68 |
BCBS Kansas City Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $5.50 | Professional | None | $3.31 | $3.31 | $5.50 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
Medica Setting Facility Modifier None Typical Low $2.88 Median $10.96 Typical High $89.13 | Facility | None | $2.88 | $10.96 | $89.13 |
Medica Setting Professional Modifier None Typical Low $1.91 Median $2.69 Typical High $83.18 | Professional | None | $1.91 | $2.69 | $83.18 |
United Setting Professional Modifier None Typical Low $1.78 Median $2.69 Typical High $4.37 | Professional | None | $1.78 | $2.69 | $4.37 |
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 $1.15 Median $1.66 Typical High $2.69 | Professional | 52 · Reduced service | $1.15 | $1.66 | $2.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.46 Median $0.66 Typical High $1.07 | Professional | 53 · Discontinued | $0.46 | $0.66 | $1.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.74 Median $2.45 Typical High $4.07 | Professional | 54 · Surgery only | $1.74 | $2.45 | $4.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.35 Median $0.49 Typical High $0.81 | Professional | 55 · Aftercare only | $0.35 | $0.49 | $0.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.23 Median $0.33 Typical High $0.54 | Professional | 56 · Pre-op care only | $0.23 | $0.33 | $0.54 |
Where Missouri sits
The same service costs 3.8 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
$3.09
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.