How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $1.26 Median $1.26 Typical High $1.26 | Facility | None | $1.26 | $1.26 | $1.26 |
Aetna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | None | $1.26 | $1.26 | $1.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.19 Median $0.19 Typical High $0.19 | Professional | 55 · Aftercare only | $0.19 | $0.19 | $0.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $0.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $154.88 | Professional | None | $125.89 | $125.89 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
Medica Setting Facility Modifier None Typical Low $1.26 Median $89.13 Typical High $100.00 | Facility | None | $1.26 | $89.13 | $100.00 |
Medica Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
1 more rate 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 |
|---|---|---|---|---|---|
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $95.50 Median $112.20 Typical High $117.49 | Professional | UE · Used equipment | $95.50 | $112.20 | $117.49 |
Where Missouri sits
The same service costs 63.1 times more in Montana than in Washington, DC. 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· 2nd of 51
$77.62
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.