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 $85.11 Median $85.11 Typical High $97.72 | Facility | None | $85.11 | $85.11 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $89.13 Typical High $97.72 | Professional | None | $85.11 | $89.13 | $97.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $758.58 | Facility | None | $165.96 | $165.96 | $758.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $91.20 Typical High $131.83 | Professional | None | $70.79 | $91.20 | $131.83 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $53.70 Median $54.95 Typical High $114.82 | Professional | UE · Used equipment | $53.70 | $54.95 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $100.00 | Facility | None | $77.62 | $77.62 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $77.62 | Professional | None | $56.23 | $56.23 | $77.62 |
Medica Setting Facility Modifier None Typical Low $67.61 Median $154.88 Typical High $645.65 | Facility | None | $67.61 | $154.88 | $645.65 |
Medica Setting Professional Modifier None Typical Low $53.70 Median $81.28 Typical High $776.25 | Professional | None | $53.70 | $81.28 | $776.25 |
United Setting Facility Modifier None Typical Low $60.26 Median $81.28 Typical High $165.96 | Facility | None | $60.26 | $81.28 | $165.96 |
United Setting Professional Modifier None Typical Low $50.12 Median $74.13 Typical High $117.49 | Professional | None | $50.12 | $74.13 | $117.49 |
6 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 $42.66 Median $44.67 Typical High $47.86 | Professional | 52 · Reduced service | $42.66 | $44.67 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $17.78 Typical High $19.50 | Professional | 53 · Discontinued | $16.98 | $17.78 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $13.18 Typical High $14.45 | Professional | 55 · Aftercare only | $12.59 | $13.18 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.91 Typical High $9.77 | Professional | 56 · Pre-op care only | $8.51 | $8.91 | $9.77 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | KX · Policy requirements met | $147.91 | $147.91 | $147.91 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.41 Median $7.41 Typical High $75.86 | Professional | RR · Rental | $7.41 | $7.41 | $75.86 |
Where Missouri sits
The same service costs 3.1 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· 24th of 51
$83.18
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.