How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $11.48 Median $26.30 Typical High $26.30 | Facility | None | $11.48 | $26.30 | $26.30 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $16.22 Typical High $26.30 | Professional | None | $11.48 | $16.22 | $26.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.75 Median $12.88 Typical High $22.39 | Professional | None | $11.75 | $12.88 | $22.39 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $9.55 Median $11.22 Typical High $18.20 | Professional | UE · Used equipment | $9.55 | $11.22 | $18.20 |
BCBS Kansas City Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $25.70 | Professional | None | $15.49 | $15.49 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Medica Setting Facility Modifier None Typical Low $14.79 Median $51.29 Typical High $120.23 | Facility | None | $14.79 | $51.29 | $120.23 |
Medica Setting Professional Modifier None Typical Low $10.96 Median $13.18 Typical High $125.89 | Professional | None | $10.96 | $13.18 | $125.89 |
United Setting Professional Modifier None Typical Low $9.77 Median $13.18 Typical High $23.44 | Professional | None | $9.77 | $13.18 | $23.44 |
4 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 $5.75 Median $8.13 Typical High $13.18 | Professional | 52 · Reduced service | $5.75 | $8.13 | $13.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $3.24 Typical High $5.37 | Professional | 53 · Discontinued | $2.29 | $3.24 | $5.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $2.45 Typical High $3.98 | Professional | 55 · Aftercare only | $1.70 | $2.45 | $3.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.62 Typical High $2.63 | Professional | 56 · Pre-op care only | $1.12 | $1.62 | $2.63 |
Where Missouri sits
The same service costs 2.6 times more in Hawaii than in Kentucky. 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· 48th 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.