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 $371.54 Median $371.54 Typical High $426.58 | Facility | None | $371.54 | $371.54 | $426.58 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $389.05 Typical High $426.58 | Professional | None | $371.54 | $389.05 | $426.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $3,311.31 | Facility | None | $724.44 | $724.44 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $416.87 Typical High $575.44 | Professional | None | $338.84 | $416.87 | $575.44 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $257.04 Median $302.00 Typical High $457.09 | Professional | UE · Used equipment | $257.04 | $302.00 | $457.09 |
BCBS Kansas City Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $724.44 | Professional | None | $436.52 | $436.52 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $616.60 | Facility | None | $380.19 | $380.19 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $380.19 | Professional | None | $275.42 | $275.42 | $380.19 |
Medica Setting Facility Modifier None Typical Low $346.74 Median $707.95 Typical High $3,090.30 | Facility | None | $346.74 | $707.95 | $3,090.30 |
Medica Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $4,168.69 | Professional | None | $239.88 | $354.81 | $4,168.69 |
United Setting Facility Modifier None Typical Low $389.05 Median $467.74 Typical High $794.33 | Facility | None | $389.05 | $467.74 | $794.33 |
United Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $524.81 | Professional | None | $234.42 | $338.84 | $524.81 |
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 $186.21 Median $194.98 Typical High $213.80 | Professional | 52 · Reduced service | $186.21 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $77.62 Typical High $85.11 | Professional | 53 · Discontinued | $74.13 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $58.88 Typical High $64.57 | Professional | 55 · Aftercare only | $56.23 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $38.90 Typical High $42.66 | Professional | 56 · Pre-op care only | $37.15 | $38.90 | $42.66 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $35.48 Median $35.48 Typical High $354.81 | Professional | RR · Rental | $35.48 | $35.48 | $354.81 |
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· 28th of 51
$372
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.