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 $5.13 Median $12.02 Typical High $12.02 | Facility | None | $5.13 | $12.02 | $12.02 |
Aetna Setting Professional Modifier None Typical Low $5.13 Median $7.24 Typical High $12.02 | Professional | None | $5.13 | $7.24 | $12.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.03 Median $7.59 Typical High $10.00 | Professional | None | $6.03 | $7.59 | $10.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.47 Median $4.79 Typical High $8.51 | Professional | UE · Used equipment | $4.47 | $4.79 | $8.51 |
BCBS Kansas City Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $12.02 | Professional | None | $7.24 | $7.24 | $12.02 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.59 | Facility | None | $7.08 | $7.08 | $7.59 |
Cigna Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $7.08 | Professional | None | $6.03 | $6.03 | $7.08 |
Medica Setting Facility Modifier None Typical Low $6.17 Median $12.02 Typical High $79.43 | Facility | None | $6.17 | $12.02 | $79.43 |
Medica Setting Professional Modifier None Typical Low $4.17 Median $5.89 Typical High $58.88 | Professional | None | $4.17 | $5.89 | $58.88 |
United Setting Professional Modifier None Typical Low $3.98 Median $5.75 Typical High $8.51 | Professional | None | $3.98 | $5.75 | $8.51 |
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 $2.51 Median $3.63 Typical High $5.89 | Professional | 52 · Reduced service | $2.51 | $3.63 | $5.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.02 Median $1.45 Typical High $2.40 | Professional | 53 · Discontinued | $1.02 | $1.45 | $2.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.78 Median $1.10 Typical High $1.78 | Professional | 55 · Aftercare only | $0.78 | $1.10 | $1.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.51 Median $0.72 Typical High $1.20 | Professional | 56 · Pre-op care only | $0.51 | $0.72 | $1.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.60 Median $0.60 Typical High $6.31 | Professional | RR · Rental | $0.60 | $0.60 | $6.31 |
Where Missouri sits
The same service costs 2.1 times more in Hawaii than in Delaware. 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
$6.76
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.