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 $2.04 Median $4.79 Typical High $4.79 | Facility | None | $2.04 | $4.79 | $4.79 |
Aetna Setting Professional Modifier None Typical Low $2.04 Median $2.88 Typical High $4.79 | Professional | None | $2.04 | $2.88 | $4.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.82 Median $3.02 Typical High $3.98 | Professional | None | $2.82 | $3.02 | $3.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.09 Median $2.24 Typical High $3.39 | Professional | UE · Used equipment | $2.09 | $2.24 | $3.39 |
BCBS Kansas City Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $4.79 | Professional | None | $2.88 | $2.88 | $4.79 |
Cigna Setting Facility Modifier None Typical Low $2.69 Median $2.82 Typical High $3.09 | Facility | None | $2.69 | $2.82 | $3.09 |
Cigna Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $2.69 | Professional | None | $2.40 | $2.40 | $2.69 |
Medica Setting Facility Modifier None Typical Low $2.45 Median $4.79 Typical High $79.43 | Facility | None | $2.45 | $4.79 | $79.43 |
Medica Setting Professional Modifier None Typical Low $1.70 Median $2.34 Typical High $23.44 | Professional | None | $1.70 | $2.34 | $23.44 |
United Setting Professional Modifier None Typical Low $1.58 Median $2.34 Typical High $3.63 | Professional | None | $1.58 | $2.34 | $3.63 |
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 $1.02 Median $1.45 Typical High $2.34 | Professional | 52 · Reduced service | $1.02 | $1.45 | $2.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.41 Median $0.58 Typical High $0.95 | Professional | 53 · Discontinued | $0.41 | $0.58 | $0.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.30 Median $0.43 Typical High $0.71 | Professional | 55 · Aftercare only | $0.30 | $0.43 | $0.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.28 Typical High $0.47 | Professional | 56 · Pre-op care only | $0.20 | $0.28 | $0.47 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.30 Median $0.30 Typical High $0.33 | Professional | RR · Rental | $0.30 | $0.30 | $0.33 |
Where Missouri sits
The same service costs 2.2 times more in Kansas than in New Jersey. 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· 33rd of 51
$3.02
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.