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 $20.89 Median $20.89 Typical High $23.99 | Facility | None | $20.89 | $20.89 | $23.99 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $21.88 Typical High $26.30 | Professional | None | $17.78 | $21.88 | $26.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $186.21 | Facility | None | $40.74 | $40.74 | $186.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.38 Median $24.55 Typical High $32.36 | Professional | None | $17.38 | $24.55 | $32.36 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $13.18 Median $13.49 Typical High $28.18 | Professional | UE · Used equipment | $13.18 | $13.49 | $28.18 |
Cigna Setting Facility Modifier None Typical Low $22.39 Median $22.39 Typical High $31.62 | Facility | None | $22.39 | $22.39 | $31.62 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $22.39 | Professional | None | $16.22 | $16.22 | $22.39 |
Medica Setting Facility Modifier None Typical Low $16.60 Median $39.81 Typical High $162.18 | Facility | None | $16.60 | $39.81 | $162.18 |
Medica Setting Professional Modifier None Typical Low $13.18 Median $19.95 Typical High $245.47 | Professional | None | $13.18 | $19.95 | $245.47 |
United Setting Facility Modifier None Typical Low $19.95 Median $28.18 Typical High $40.74 | Facility | None | $19.95 | $28.18 | $40.74 |
United Setting Professional Modifier None Typical Low $12.30 Median $18.20 Typical High $28.84 | Professional | None | $12.30 | $18.20 | $28.84 |
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 $10.47 Median $10.96 Typical High $12.02 | Professional | 52 · Reduced service | $10.47 | $10.96 | $12.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.37 Typical High $4.79 | Professional | 53 · Discontinued | $4.17 | $4.37 | $4.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.31 Typical High $3.63 | Professional | 55 · Aftercare only | $3.16 | $3.31 | $3.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.19 Typical High $2.40 | Professional | 56 · Pre-op care only | $2.09 | $2.19 | $2.40 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.82 Median $1.82 Typical High $18.62 | Professional | RR · Rental | $1.82 | $1.82 | $18.62 |
Where Missouri sits
The same service costs 3.7 times more in Hawaii than in Florida. 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· 24th of 51
$20.89
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.