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 $15.49 Median $19.50 Typical High $41.69 | Facility | None | $15.49 | $19.50 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $15.49 Median $29.51 Typical High $38.90 | Professional | None | $15.49 | $29.51 | $38.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $204.17 Median $3,467.37 Typical High $7,079.46 | Facility | None | $204.17 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.95 Median $39.81 Typical High $52.48 | Professional | None | $19.95 | $39.81 | $52.48 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $30.20 Median $58.88 Typical High $77.62 | Professional | 50 · Both sides | $30.20 | $58.88 | $77.62 |
BCBS Kansas City Setting Professional Modifier None Typical Low $16.22 Median $33.88 Typical High $43.65 | Professional | None | $16.22 | $33.88 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $66.07 | Facility | None | $50.12 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $35.48 Typical High $70.79 | Professional | None | $18.62 | $35.48 | $70.79 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $181.97 Typical High $1,288.25 | Facility | None | $54.95 | $181.97 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $40.74 Median $194.98 Typical High $323.59 | Professional | None | $40.74 | $194.98 | $323.59 |
United Setting Facility Modifier None Typical Low $123.03 Median $537.03 Typical High $2,137.96 | Facility | None | $123.03 | $537.03 | $2,137.96 |
United Setting Professional Modifier None Typical Low $19.95 Median $40.74 Typical High $61.66 | Professional | None | $19.95 | $40.74 | $61.66 |
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 $7.76 Median $14.79 Typical High $18.20 | Professional | 52 · Reduced service | $7.76 | $14.79 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $5.89 Typical High $7.24 | Professional | 53 · Discontinued | $3.09 | $5.89 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $4.37 Typical High $5.37 | Professional | 55 · Aftercare only | $2.29 | $4.37 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $2.95 Typical High $3.63 | Professional | 56 · Pre-op care only | $1.55 | $2.95 | $3.63 |
Ambetter Setting Professional Modifier GP · Physical therapy plan Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | GP · Physical therapy plan | $31.62 | $31.62 | $31.62 |
Where Missouri sits
The same service costs 3.8 times more in Alaska than in Virginia. 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· 17th of 51
$43.65
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.