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 $2.45 Median $5.75 Typical High $5.75 | Facility | None | $2.45 | $5.75 | $5.75 |
Aetna Setting Professional Modifier None Typical Low $2.45 Median $3.98 Typical High $5.75 | Professional | None | $2.45 | $3.98 | $5.75 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.34 Median $3.24 Typical High $5.01 | Professional | None | $2.34 | $3.24 | $5.01 |
BCBS Kansas City Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $5.75 | Professional | None | $3.47 | $3.47 | $5.75 |
Cigna Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $2.34 | Professional | None | $2.34 | $2.34 | $2.34 |
Medica Setting Facility Modifier None Typical Low $3.02 Median $11.48 Typical High $89.13 | Facility | None | $3.02 | $11.48 | $89.13 |
Medica Setting Professional Modifier None Typical Low $2.04 Median $2.82 Typical High $69.18 | Professional | None | $2.04 | $2.82 | $69.18 |
United Setting Professional Modifier None Typical Low $1.91 Median $2.82 Typical High $4.68 | Professional | None | $1.91 | $2.82 | $4.68 |
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 $1.23 Median $1.74 Typical High $2.82 | Professional | 52 · Reduced service | $1.23 | $1.74 | $2.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.49 Median $0.69 Typical High $1.12 | Professional | 53 · Discontinued | $0.49 | $0.69 | $1.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.82 Median $2.57 Typical High $4.27 | Professional | 54 · Surgery only | $1.82 | $2.57 | $4.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.37 Median $0.52 Typical High $0.85 | Professional | 55 · Aftercare only | $0.37 | $0.52 | $0.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.24 Median $0.35 Typical High $0.56 | Professional | 56 · Pre-op care only | $0.24 | $0.35 | $0.56 |
Where Missouri sits
The same service costs 3.0 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
$3.24
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.