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 $95.50 Median $95.50 Typical High $109.65 | Facility | None | $95.50 | $95.50 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $100.00 Typical High $112.20 | Professional | None | $95.50 | $100.00 | $112.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $870.96 | Facility | None | $186.21 | $186.21 | $870.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $114.82 Typical High $151.36 | Professional | None | $107.15 | $114.82 | $151.36 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $77.62 Median $83.18 Typical High $128.82 | Professional | UE · Used equipment | $77.62 | $83.18 | $128.82 |
BCBS Kansas City Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $186.21 | Professional | None | $112.20 | $112.20 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $134.90 | Facility | None | $125.89 | $125.89 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $125.89 | Professional | None | $91.20 | $91.20 | $125.89 |
Medica Setting Facility Modifier None Typical Low $100.00 Median $181.97 Typical High $1,000.00 | Facility | None | $100.00 | $181.97 | $1,000.00 |
Medica Setting Professional Modifier None Typical Low $75.86 Median $91.20 Typical High $1,174.90 | Professional | None | $75.86 | $91.20 | $1,174.90 |
United Setting Facility Modifier None Typical Low $87.10 Median $100.00 Typical High $251.19 | Facility | None | $87.10 | $100.00 | $251.19 |
United Setting Professional Modifier None Typical Low $69.18 Median $91.20 Typical High $141.25 | Professional | None | $69.18 | $91.20 | $141.25 |
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 $47.86 Median $50.12 Typical High $54.95 | Professional | 52 · Reduced service | $47.86 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $20.42 Typical High $21.88 | Professional | 53 · Discontinued | $19.05 | $20.42 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $15.14 Typical High $16.60 | Professional | 55 · Aftercare only | $14.45 | $15.14 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $10.00 Typical High $10.96 | Professional | 56 · Pre-op care only | $9.55 | $10.00 | $10.96 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.22 Median $11.22 Typical High $112.20 | Professional | RR · Rental | $11.22 | $11.22 | $112.20 |
Where Missouri sits
The same service costs 2.4 times more in Hawaii than in Delaware. 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· 41st of 51
$112
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.