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 $5.01 Median $11.75 Typical High $11.75 | Facility | None | $5.01 | $11.75 | $11.75 |
Aetna Setting Professional Modifier None Typical Low $5.01 Median $7.08 Typical High $11.75 | Professional | None | $5.01 | $7.08 | $11.75 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.79 Median $6.61 Typical High $9.55 | Professional | None | $4.79 | $6.61 | $9.55 |
BCBS Kansas City Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $12.02 | Professional | None | $7.08 | $7.08 | $12.02 |
Cigna Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
Medica Setting Facility Modifier None Typical Low $6.17 Median $23.44 Typical High $89.13 | Facility | None | $6.17 | $23.44 | $89.13 |
Medica Setting Professional Modifier None Typical Low $4.17 Median $5.75 Typical High $138.04 | Professional | None | $4.17 | $5.75 | $138.04 |
United Setting Professional Modifier None Typical Low $3.89 Median $5.75 Typical High $9.55 | Professional | None | $3.89 | $5.75 | $9.55 |
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 $2.51 Median $3.55 Typical High $5.89 | Professional | 52 · Reduced service | $2.51 | $3.55 | $5.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.00 Median $1.41 Typical High $2.34 | Professional | 53 · Discontinued | $1.00 | $1.41 | $2.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3.72 Median $5.37 Typical High $8.71 | Professional | 54 · Surgery only | $3.72 | $5.37 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.76 Median $1.07 Typical High $1.74 | Professional | 55 · Aftercare only | $0.76 | $1.07 | $1.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.50 Median $0.71 Typical High $1.17 | Professional | 56 · Pre-op care only | $0.50 | $0.71 | $1.17 |
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
$6.61
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.