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 $204.17 Median $218.78 Typical High $251.19 | Professional | None | $204.17 | $218.78 | $251.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $1,737.80 | Facility | None | $380.19 | $380.19 | $1,737.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $478.63 | Professional | None | $263.03 | $331.13 | $478.63 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $190.55 Median $245.47 Typical High $398.11 | Professional | UE · Used equipment | $190.55 | $245.47 | $398.11 |
BCBS Kansas City Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $380.19 | Professional | None | $223.87 | $223.87 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $407.38 | Facility | None | $380.19 | $380.19 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $380.19 | Professional | None | $281.84 | $281.84 | $380.19 |
Medica Setting Facility Modifier None Typical Low $213.80 Median $389.05 Typical High $1,659.59 | Facility | None | $213.80 | $389.05 | $1,659.59 |
Medica Setting Professional Modifier None Typical Low $213.80 Median $275.42 Typical High $2,570.40 | Professional | None | $213.80 | $275.42 | $2,570.40 |
United Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Facility | None | $933.25 | $933.25 | $933.25 |
United Setting Professional Modifier None Typical Low $186.21 Median $269.15 Typical High $407.38 | Professional | None | $186.21 | $269.15 | $407.38 |
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 $100.00 Median $109.65 Typical High $125.89 | Professional | 52 · Reduced service | $100.00 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $43.65 Typical High $50.12 | Professional | 53 · Discontinued | $40.74 | $43.65 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $33.11 Typical High $38.02 | Professional | 55 · Aftercare only | $30.20 | $33.11 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $21.88 Typical High $25.12 | Professional | 56 · Pre-op care only | $20.42 | $21.88 | $25.12 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $27.54 Median $33.11 Typical High $331.13 | Professional | RR · Rental | $27.54 | $33.11 | $331.13 |
Where Missouri sits
The same service costs 3.0 times more in Hawaii than in Utah. 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· 45th of 51
$282
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.