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 $48.98 Median $50.12 Typical High $79.43 | Facility | None | $48.98 | $50.12 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $52.48 Typical High $57.54 | Professional | None | $50.12 | $52.48 | $57.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $457.09 | Facility | None | $97.72 | $97.72 | $457.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $58.88 Typical High $79.43 | Professional | None | $42.66 | $58.88 | $79.43 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $31.62 Median $31.62 Typical High $67.61 | Professional | UE · Used equipment | $31.62 | $31.62 | $67.61 |
BCBS Kansas City Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $97.72 | Professional | None | $58.88 | $58.88 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $50.12 | Facility | None | $46.77 | $46.77 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $46.77 | Professional | None | $33.88 | $33.88 | $46.77 |
Medica Setting Facility Modifier None Typical Low $39.81 Median $93.33 Typical High $380.19 | Facility | None | $39.81 | $93.33 | $380.19 |
Medica Setting Professional Modifier None Typical Low $31.62 Median $47.86 Typical High $478.63 | Professional | None | $31.62 | $47.86 | $478.63 |
United Setting Facility Modifier None Typical Low $19.05 Median $36.31 Typical High $97.72 | Facility | None | $19.05 | $36.31 | $97.72 |
United Setting Professional Modifier None Typical Low $30.20 Median $44.67 Typical High $69.18 | Professional | None | $30.20 | $44.67 | $69.18 |
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 $25.12 Median $26.30 Typical High $28.84 | Professional | 52 · Reduced service | $25.12 | $26.30 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.47 Typical High $11.48 | Professional | 53 · Discontinued | $10.00 | $10.47 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.94 Typical High $8.71 | Professional | 55 · Aftercare only | $7.59 | $7.94 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.25 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.01 | $5.25 | $5.75 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.27 Median $4.27 Typical High $43.65 | Professional | RR · Rental | $4.27 | $4.27 | $43.65 |
Where Missouri sits
The same service costs 2.9 times more in Kansas 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· 24th of 51
$50.12
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.