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 $28.18 Median $66.07 Typical High $66.07 | Facility | None | $28.18 | $66.07 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $40.74 Typical High $66.07 | Professional | None | $28.18 | $40.74 | $66.07 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.90 Median $42.66 Typical High $114.82 | Professional | None | $38.90 | $42.66 | $114.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $28.18 Median $33.88 Typical High $87.10 | Professional | UE · Used equipment | $28.18 | $33.88 | $87.10 |
BCBS Kansas City Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $67.61 | Professional | None | $40.74 | $40.74 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $48.98 | Facility | None | $39.81 | $39.81 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $39.81 | Professional | None | $33.88 | $33.88 | $39.81 |
Medica Setting Facility Modifier None Typical Low $33.88 Median $66.07 Typical High $309.03 | Facility | None | $33.88 | $66.07 | $309.03 |
Medica Setting Professional Modifier None Typical Low $23.44 Median $33.11 Typical High $331.13 | Professional | None | $23.44 | $33.11 | $331.13 |
United Setting Professional Modifier None Typical Low $21.88 Median $33.11 Typical High $51.29 | Professional | None | $21.88 | $33.11 | $51.29 |
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 $14.13 Median $20.42 Typical High $33.11 | Professional | 52 · Reduced service | $14.13 | $20.42 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $8.13 Typical High $13.18 | Professional | 53 · Discontinued | $5.62 | $8.13 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $6.03 Typical High $10.00 | Professional | 55 · Aftercare only | $4.27 | $6.03 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $4.07 Typical High $6.61 | Professional | 56 · Pre-op care only | $2.82 | $4.07 | $6.61 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.48 Median $11.48 Typical High $114.82 | Professional | RR · Rental | $11.48 | $11.48 | $114.82 |
Where Missouri sits
The same service costs 2.3 times more in Kansas than in Alabama. 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· 30th of 51
$42.66
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.