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 $3.55 Median $7.59 Typical High $8.32 | Facility | None | $3.55 | $7.59 | $8.32 |
Aetna Setting Professional Modifier None Typical Low $3.55 Median $5.01 Typical High $8.32 | Professional | None | $3.55 | $5.01 | $8.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.63 Median $5.01 Typical High $7.08 | Professional | None | $3.63 | $5.01 | $7.08 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.75 Median $3.24 Typical High $6.03 | Professional | UE · Used equipment | $2.75 | $3.24 | $6.03 |
BCBS Kansas City Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $8.32 | Professional | None | $5.01 | $5.01 | $8.32 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Medica Setting Facility Modifier None Typical Low $4.57 Median $10.00 Typical High $79.43 | Facility | None | $4.57 | $10.00 | $79.43 |
Medica Setting Professional Modifier None Typical Low $2.95 Median $4.07 Typical High $40.74 | Professional | None | $2.95 | $4.07 | $40.74 |
United Setting Professional Modifier None Typical Low $2.75 Median $4.07 Typical High $6.76 | Professional | None | $2.75 | $4.07 | $6.76 |
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 $1.78 Median $2.51 Typical High $4.07 | Professional | 52 · Reduced service | $1.78 | $2.51 | $4.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.71 Median $1.00 Typical High $1.66 | Professional | 53 · Discontinued | $0.71 | $1.00 | $1.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.76 Typical High $1.23 | Professional | 55 · Aftercare only | $0.52 | $0.76 | $1.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.50 Typical High $0.81 | Professional | 56 · Pre-op care only | $0.35 | $0.50 | $0.81 |
Where Missouri sits
The same service costs 2.6 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· 23rd of 51
$5.01
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.