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 $2.14 Median $5.01 Typical High $5.01 | Facility | None | $2.14 | $5.01 | $5.01 |
Aetna Setting Professional Modifier None Typical Low $2.14 Median $3.02 Typical High $5.01 | Professional | None | $2.14 | $3.02 | $5.01 |
Ambetter Setting Professional Modifier None Typical Low $2.40 Median $5.13 Typical High $5.50 | Professional | None | $2.40 | $5.13 | $5.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.51 Median $3.31 Typical High $4.27 | Professional | None | $2.51 | $3.31 | $4.27 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.86 Median $2.19 Typical High $3.55 | Professional | UE · Used equipment | $1.86 | $2.19 | $3.55 |
BCBS Kansas City Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $5.13 | Professional | None | $3.09 | $3.09 | $5.13 |
Cigna Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.24 | Facility | None | $3.02 | $3.02 | $3.24 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $3.02 | Professional | None | $2.57 | $2.57 | $3.02 |
Medica Setting Facility Modifier None Typical Low $2.57 Median $5.01 Typical High $79.43 | Facility | None | $2.57 | $5.01 | $79.43 |
Medica Setting Professional Modifier None Typical Low $1.78 Median $2.51 Typical High $25.12 | Professional | None | $1.78 | $2.51 | $25.12 |
United Setting Professional Modifier None Typical Low $1.66 Median $2.40 Typical High $3.55 | Professional | None | $1.66 | $2.40 | $3.55 |
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 $1.07 Median $1.51 Typical High $2.51 | Professional | 52 · Reduced service | $1.07 | $1.51 | $2.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.43 Median $0.62 Typical High $1.00 | Professional | 53 · Discontinued | $0.43 | $0.62 | $1.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.32 Median $0.46 Typical High $0.76 | Professional | 55 · Aftercare only | $0.32 | $0.46 | $0.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.31 Typical High $0.50 | Professional | 56 · Pre-op care only | $0.21 | $0.31 | $0.50 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.25 Median $0.25 Typical High $2.63 | Professional | RR · Rental | $0.25 | $0.25 | $2.63 |
Where Missouri sits
The same service costs 2.3 times more in Kansas than in Connecticut. 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
$2.75
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.