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 $35.48 Median $35.48 Typical High $40.74 | Facility | None | $35.48 | $35.48 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $35.48 Typical High $41.69 | Professional | None | $31.62 | $35.48 | $41.69 |
Ambetter Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $275.42 | Facility | None | $58.88 | $58.88 | $275.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $53.70 Typical High $79.43 | Professional | None | $43.65 | $53.70 | $79.43 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $30.20 Median $40.74 Typical High $66.07 | Professional | UE · Used equipment | $30.20 | $40.74 | $66.07 |
BCBS Kansas City Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $58.88 | Professional | None | $35.48 | $35.48 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $57.54 | Facility | None | $52.48 | $52.48 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $52.48 | Professional | None | $44.67 | $44.67 | $52.48 |
Medica Setting Facility Modifier None Typical Low $33.88 Median $66.07 Typical High $257.04 | Facility | None | $33.88 | $66.07 | $257.04 |
Medica Setting Professional Modifier None Typical Low $34.67 Median $46.77 Typical High $389.05 | Professional | None | $34.67 | $46.77 | $389.05 |
United Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
United Setting Professional Modifier None Typical Low $30.90 Median $44.67 Typical High $66.07 | Professional | None | $30.90 | $44.67 | $66.07 |
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 $15.85 Median $17.78 Typical High $20.42 | Professional | 52 · Reduced service | $15.85 | $17.78 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $7.08 Typical High $8.13 | Professional | 53 · Discontinued | $6.31 | $7.08 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $5.37 Typical High $6.03 | Professional | 55 · Aftercare only | $4.79 | $5.37 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.55 Typical High $4.07 | Professional | 56 · Pre-op care only | $3.16 | $3.55 | $4.07 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.37 Median $5.37 Typical High $53.70 | Professional | RR · Rental | $5.37 | $5.37 | $53.70 |
Where Missouri sits
The same service costs 2.6 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· 35th of 51
$46.77
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.