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 $0.85 Median $2.00 Typical High $2.00 | Facility | None | $0.85 | $2.00 | $2.00 |
Aetna Setting Professional Modifier None Typical Low $0.85 Median $1.23 Typical High $2.00 | Professional | None | $0.85 | $1.23 | $2.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.00 Median $1.51 Typical High $2.19 | Professional | None | $1.00 | $1.51 | $2.19 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.74 Median $1.00 Typical High $1.29 | Professional | UE · Used equipment | $0.74 | $1.00 | $1.29 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1.23 Median $1.23 Typical High $2.04 | Professional | None | $1.23 | $1.23 | $2.04 |
Cigna Setting Facility Modifier None Typical Low $1.20 Median $1.20 Typical High $1.29 | Facility | None | $1.20 | $1.20 | $1.29 |
Cigna Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.20 | Professional | None | $1.02 | $1.02 | $1.20 |
Medica Setting Facility Modifier None Typical Low $0.98 Median $2.00 Typical High $79.43 | Facility | None | $0.98 | $2.00 | $79.43 |
Medica Setting Professional Modifier None Typical Low $0.71 Median $1.00 Typical High $9.77 | Professional | None | $0.71 | $1.00 | $9.77 |
United Setting Professional Modifier None Typical Low $0.68 Median $0.98 Typical High $1.41 | Professional | None | $0.68 | $0.98 | $1.41 |
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 $0.13 Median $0.18 Typical High $0.30 | Professional | 55 · Aftercare only | $0.13 | $0.18 | $0.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.12 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.09 | $0.12 | $0.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.10 Median $0.10 Typical High $1.05 | Professional | RR · Rental | $0.10 | $0.10 | $1.05 |
Where Missouri sits
The same service costs 2.1 times more in Kansas than in Kentucky. 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
$1.12
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.