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 $2.24 Median $5.25 Typical High $5.25 | Facility | None | $2.24 | $5.25 | $5.25 |
Aetna Setting Professional Modifier None Typical Low $2.24 Median $3.24 Typical High $5.25 | Professional | None | $2.24 | $3.24 | $5.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.63 Median $3.47 Typical High $4.47 | Professional | None | $2.63 | $3.47 | $4.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.95 Median $2.24 Typical High $3.72 | Professional | UE · Used equipment | $1.95 | $2.24 | $3.72 |
BCBS Kansas City Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $5.37 | Professional | None | $3.24 | $3.24 | $5.37 |
Cigna Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.80 | Facility | None | $3.55 | $3.55 | $3.80 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.55 | Professional | None | $2.95 | $2.95 | $3.55 |
Medica Setting Facility Modifier None Typical Low $2.69 Median $5.25 Typical High $79.43 | Facility | None | $2.69 | $5.25 | $79.43 |
Medica Setting Professional Modifier None Typical Low $1.86 Median $2.63 Typical High $26.30 | Professional | None | $1.86 | $2.63 | $26.30 |
United Setting Professional Modifier None Typical Low $1.74 Median $2.51 Typical High $3.72 | Professional | None | $1.74 | $2.51 | $3.72 |
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 $1.12 Median $1.58 Typical High $2.63 | Professional | 52 · Reduced service | $1.12 | $1.58 | $2.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.45 Median $0.65 Typical High $1.05 | Professional | 53 · Discontinued | $0.45 | $0.65 | $1.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.34 Median $0.48 Typical High $0.79 | Professional | 55 · Aftercare only | $0.34 | $0.48 | $0.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.23 Median $0.32 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.23 | $0.32 | $0.52 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.26 Median $0.26 Typical High $0.37 | Professional | RR · Rental | $0.26 | $0.26 | $0.37 |
Where Missouri sits
The same service costs 2.6 times more in Kansas than in New Hampshire. 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· 42nd of 51
$2.95
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.