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 $6.46 Median $15.14 Typical High $15.14 | Facility | None | $6.46 | $15.14 | $15.14 |
Aetna Setting Professional Modifier None Typical Low $6.46 Median $12.02 Typical High $18.20 | Professional | None | $6.46 | $12.02 | $18.20 |
Ambetter Setting Professional Modifier None Typical Low $15.49 Median $20.42 Typical High $20.42 | Professional | None | $15.49 | $20.42 | $20.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.31 Median $8.71 Typical High $12.30 | Professional | None | $6.31 | $8.71 | $12.30 |
BCBS Kansas City Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $15.49 | Professional | None | $9.33 | $9.33 | $15.49 |
Cigna Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | None | $6.31 | $6.31 | $6.31 |
Medica Setting Facility Modifier None Typical Low $8.13 Median $34.67 Typical High $125.89 | Facility | None | $8.13 | $34.67 | $125.89 |
Medica Setting Professional Modifier None Typical Low $5.37 Median $7.59 Typical High $295.12 | Professional | None | $5.37 | $7.59 | $295.12 |
United Setting Professional Modifier None Typical Low $5.01 Median $7.59 Typical High $12.30 | Professional | None | $5.01 | $7.59 | $12.30 |
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 $3.24 Median $4.68 Typical High $7.59 | Professional | 52 · Reduced service | $3.24 | $4.68 | $7.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.29 Median $1.86 Typical High $3.02 | Professional | 53 · Discontinued | $1.29 | $1.86 | $3.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4.90 Median $6.92 Typical High $11.48 | Professional | 54 · Surgery only | $4.90 | $6.92 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.98 Median $1.38 Typical High $2.29 | Professional | 55 · Aftercare only | $0.98 | $1.38 | $2.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.65 Median $0.93 Typical High $1.51 | Professional | 56 · Pre-op care only | $0.65 | $0.93 | $1.51 |
Where Missouri sits
The same service costs 4.5 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· 39th of 51
$8.71
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.