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 $218.78 Median $218.78 Typical High $251.19 | Facility | None | $218.78 | $218.78 | $251.19 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $229.09 Typical High $288.40 | Professional | None | $218.78 | $229.09 | $288.40 |
Ambetter Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $1,995.26 | Facility | None | $426.58 | $426.58 | $1,995.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $257.04 Typical High $346.74 | Professional | None | $245.47 | $257.04 | $346.74 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $177.83 Median $190.55 Typical High $295.12 | Professional | UE · Used equipment | $177.83 | $190.55 | $295.12 |
BCBS Kansas City Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $426.58 | Professional | None | $257.04 | $257.04 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $346.74 | Facility | None | $316.23 | $316.23 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | None | $229.09 | $229.09 | $316.23 |
Medica Setting Facility Modifier None Typical Low $218.78 Median $416.87 Typical High $2,187.76 | Facility | None | $218.78 | $416.87 | $2,187.76 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $208.93 Typical High $2,570.40 | Professional | None | $173.78 | $208.93 | $2,570.40 |
United Setting Facility Modifier None Typical Low $245.47 Median $269.15 Typical High $562.34 | Facility | None | $245.47 | $269.15 | $562.34 |
United Setting Professional Modifier None Typical Low $158.49 Median $208.93 Typical High $323.59 | Professional | None | $158.49 | $208.93 | $323.59 |
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 $109.65 Median $114.82 Typical High $128.82 | Professional | 52 · Reduced service | $109.65 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $46.77 Typical High $51.29 | Professional | 53 · Discontinued | $43.65 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $34.67 Typical High $38.90 | Professional | 55 · Aftercare only | $33.11 | $34.67 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $22.91 Typical High $25.70 | Professional | 56 · Pre-op care only | $21.88 | $22.91 | $25.70 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $25.12 Median $25.12 Typical High $263.03 | Professional | RR · Rental | $25.12 | $25.12 | $263.03 |
Where Missouri sits
The same service costs 2.6 times more in Hawaii than in Arizona. 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· 37th of 51
$257
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.