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 $3.63 Median $8.32 Typical High $8.32 | Facility | None | $3.63 | $8.32 | $8.32 |
Aetna Setting Professional Modifier None Typical Low $3.63 Median $6.61 Typical High $9.33 | Professional | None | $3.63 | $6.61 | $9.33 |
Ambetter Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | None | $8.51 | $8.51 | $8.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.47 Median $4.79 Typical High $7.41 | Professional | None | $3.47 | $4.79 | $7.41 |
BCBS Kansas City Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $8.51 | Professional | None | $5.13 | $5.13 | $8.51 |
Cigna Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
Medica Setting Facility Modifier None Typical Low $4.47 Median $16.98 Typical High $89.13 | Facility | None | $4.47 | $16.98 | $89.13 |
Medica Setting Professional Modifier None Typical Low $2.95 Median $4.17 Typical High $138.04 | Professional | None | $2.95 | $4.17 | $138.04 |
United Setting Professional Modifier None Typical Low $2.82 Median $4.17 Typical High $6.92 | Professional | None | $2.82 | $4.17 | $6.92 |
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 $1.82 Median $2.57 Typical High $4.17 | Professional | 52 · Reduced service | $1.82 | $2.57 | $4.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.72 Median $1.02 Typical High $1.70 | Professional | 53 · Discontinued | $0.72 | $1.02 | $1.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.69 Median $3.89 Typical High $6.31 | Professional | 54 · Surgery only | $2.69 | $3.89 | $6.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.54 Median $0.78 Typical High $1.26 | Professional | 55 · Aftercare only | $0.54 | $0.78 | $1.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.51 Typical High $0.83 | Professional | 56 · Pre-op care only | $0.36 | $0.51 | $0.83 |
Where Missouri sits
The same service costs 4.1 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· 38th of 51
$4.79
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.