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 $5.25 Median $12.30 Typical High $12.30 | Facility | None | $5.25 | $12.30 | $12.30 |
Aetna Setting Professional Modifier None Typical Low $5.25 Median $7.59 Typical High $12.30 | Professional | None | $5.25 | $7.59 | $12.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.37 Median $5.75 Typical High $11.48 | Professional | None | $5.37 | $5.75 | $11.48 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.98 Median $4.37 Typical High $8.71 | Professional | UE · Used equipment | $3.98 | $4.37 | $8.71 |
BCBS Kansas City Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $12.59 | Professional | None | $7.59 | $7.59 | $12.59 |
Cigna Setting Facility Modifier None Typical Low $5.89 Median $5.89 Typical High $6.31 | Facility | None | $5.89 | $5.89 | $6.31 |
Cigna Setting Professional Modifier None Typical Low $5.01 Median $5.13 Typical High $5.13 | Professional | None | $5.01 | $5.13 | $5.13 |
Medica Setting Facility Modifier None Typical Low $6.17 Median $12.30 Typical High $79.43 | Facility | None | $6.17 | $12.30 | $79.43 |
Medica Setting Professional Modifier None Typical Low $4.37 Median $6.17 Typical High $61.66 | Professional | None | $4.37 | $6.17 | $61.66 |
United Setting Professional Modifier None Typical Low $4.07 Median $6.17 Typical High $9.33 | Professional | None | $4.07 | $6.17 | $9.33 |
3 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 55 · Aftercare only Typical Low $0.79 Median $1.12 Typical High $1.86 | Professional | 55 · Aftercare only | $0.79 | $1.12 | $1.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.76 Typical High $1.23 | Professional | 56 · Pre-op care only | $0.52 | $0.76 | $1.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.54 Median $0.54 Typical High $0.83 | Professional | RR · Rental | $0.54 | $0.54 | $0.83 |
Where Missouri sits
The same service costs 2.7 times more in Hawaii than in Vermont. 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· 38th of 51
$5.89
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.