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 $18.62 Median $43.65 Typical High $43.65 | Facility | None | $18.62 | $43.65 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $26.30 Typical High $43.65 | Professional | None | $18.62 | $26.30 | $43.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.05 Median $21.88 Typical High $40.74 | Professional | None | $19.05 | $21.88 | $40.74 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $14.45 Median $16.60 Typical High $30.90 | Professional | UE · Used equipment | $14.45 | $16.60 | $30.90 |
BCBS Kansas City Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $43.65 | Professional | None | $26.30 | $26.30 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Medica Setting Facility Modifier None Typical Low $22.91 Median $87.10 Typical High $204.17 | Facility | None | $22.91 | $87.10 | $204.17 |
Medica Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $213.80 | Professional | None | $15.14 | $15.14 | $213.80 |
United Setting Professional Modifier None Typical Low $13.49 Median $15.14 Typical High $17.38 | Professional | None | $13.49 | $15.14 | $17.38 |
4 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 $9.33 Median $13.18 Typical High $21.88 | Professional | 52 · Reduced service | $9.33 | $13.18 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $5.25 Typical High $8.71 | Professional | 53 · Discontinued | $3.72 | $5.25 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $3.98 Typical High $6.46 | Professional | 55 · Aftercare only | $2.75 | $3.98 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $2.63 Typical High $4.37 | Professional | 56 · Pre-op care only | $1.86 | $2.63 | $4.37 |
Where Missouri sits
The same service costs 3.2 times more in Hawaii than in Utah. 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
$21.88
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.