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 $10.00 Median $23.44 Typical High $23.44 | Facility | None | $10.00 | $23.44 | $23.44 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $14.13 Typical High $23.44 | Professional | None | $10.00 | $14.13 | $23.44 |
Ambetter Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.55 Median $13.18 Typical High $20.42 | Professional | None | $9.55 | $13.18 | $20.42 |
BCBS Kansas City Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $23.99 | Professional | None | $14.13 | $14.13 | $23.99 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Medica Setting Facility Modifier None Typical Low $12.30 Median $47.86 Typical High $117.49 | Facility | None | $12.30 | $47.86 | $117.49 |
Medica Setting Professional Modifier None Typical Low $8.32 Median $11.75 Typical High $269.15 | Professional | None | $8.32 | $11.75 | $269.15 |
United Setting Professional Modifier None Typical Low $7.76 Median $11.48 Typical High $19.05 | Professional | None | $7.76 | $11.48 | $19.05 |
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 $5.01 Median $7.08 Typical High $11.75 | Professional | 52 · Reduced service | $5.01 | $7.08 | $11.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.82 Typical High $4.68 | Professional | 53 · Discontinued | $2.00 | $2.82 | $4.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.41 Median $10.72 Typical High $17.38 | Professional | 54 · Surgery only | $7.41 | $10.72 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $2.14 Typical High $3.47 | Professional | 55 · Aftercare only | $1.51 | $2.14 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.41 Typical High $2.34 | Professional | 56 · Pre-op care only | $1.00 | $1.41 | $2.34 |
Where Missouri sits
The same service costs 2.9 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
$13.18
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.