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 $2.82 Median $6.61 Typical High $6.61 | Facility | None | $2.82 | $6.61 | $6.61 |
Aetna Setting Professional Modifier None Typical Low $2.82 Median $4.07 Typical High $6.61 | Professional | None | $2.82 | $4.07 | $6.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.31 Median $4.27 Typical High $5.62 | Professional | None | $3.31 | $4.27 | $5.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.51 Median $2.82 Typical High $4.79 | Professional | UE · Used equipment | $2.51 | $2.82 | $4.79 |
BCBS Kansas City Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $6.76 | Professional | None | $4.07 | $4.07 | $6.76 |
Cigna Setting Facility Modifier None Typical Low $3.98 Median $3.98 Typical High $4.27 | Facility | None | $3.98 | $3.98 | $4.27 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.98 | Professional | None | $3.39 | $3.39 | $3.98 |
Medica Setting Facility Modifier None Typical Low $3.47 Median $6.61 Typical High $79.43 | Facility | None | $3.47 | $6.61 | $79.43 |
Medica Setting Professional Modifier None Typical Low $2.34 Median $3.31 Typical High $33.11 | Professional | None | $2.34 | $3.31 | $33.11 |
United Setting Professional Modifier None Typical Low $2.19 Median $3.24 Typical High $4.68 | Professional | None | $2.19 | $3.24 | $4.68 |
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 $1.45 Median $2.04 Typical High $3.31 | Professional | 52 · Reduced service | $1.45 | $2.04 | $3.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.56 Median $0.81 Typical High $1.32 | Professional | 53 · Discontinued | $0.56 | $0.81 | $1.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.43 Median $0.62 Typical High $1.00 | Professional | 55 · Aftercare only | $0.43 | $0.62 | $1.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.41 Typical High $0.68 | Professional | 56 · Pre-op care only | $0.28 | $0.41 | $0.68 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.33 Median $0.33 Typical High $3.55 | Professional | RR · Rental | $0.33 | $0.33 | $3.55 |
Where Missouri sits
The same service costs 2.1 times more in Kansas than in Alabama. 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· 37th of 51
$3.72
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.