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 $1.82 Median $4.27 Typical High $4.27 | Facility | None | $1.82 | $4.27 | $4.27 |
Aetna Setting Professional Modifier None Typical Low $1.82 Median $3.02 Typical High $4.27 | Professional | None | $1.82 | $3.02 | $4.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.74 Median $2.40 Typical High $3.72 | Professional | None | $1.74 | $2.40 | $3.72 |
BCBS Kansas City Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $4.27 | Professional | None | $2.57 | $2.57 | $4.27 |
Cigna Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $1.78 | Professional | None | $1.78 | $1.78 | $1.78 |
Medica Setting Facility Modifier None Typical Low $2.24 Median $8.51 Typical High $89.13 | Facility | None | $2.24 | $8.51 | $89.13 |
Medica Setting Professional Modifier None Typical Low $1.51 Median $2.09 Typical High $69.18 | Professional | None | $1.51 | $2.09 | $69.18 |
United Setting Professional Modifier None Typical Low $1.41 Median $2.09 Typical High $3.47 | Professional | None | $1.41 | $2.09 | $3.47 |
6 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 $0.91 Median $1.29 Typical High $2.14 | Professional | 52 · Reduced service | $0.91 | $1.29 | $2.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.36 Median $0.52 Typical High $0.85 | Professional | 53 · Discontinued | $0.36 | $0.52 | $0.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.35 Median $1.95 Typical High $3.16 | Professional | 54 · Surgery only | $1.35 | $1.95 | $3.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.27 Median $0.39 Typical High $0.63 | Professional | 55 · Aftercare only | $0.27 | $0.39 | $0.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.18 Median $0.26 Typical High $0.42 | Professional | 56 · Pre-op care only | $0.18 | $0.26 | $0.42 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | UE · Used equipment | $3.24 | $3.24 | $3.24 |
Where Missouri sits
The same service costs 4.0 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· 37th of 51
$2.40
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.