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 $186.21 Median $186.21 Typical High $213.80 | Facility | None | $186.21 | $186.21 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $186.21 Typical High $263.03 | Professional | None | $165.96 | $186.21 | $263.03 |
Ambetter Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $354.81 | Professional | None | $309.03 | $309.03 | $354.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $1,445.44 | Facility | None | $316.23 | $316.23 | $1,445.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $281.84 Typical High $416.87 | Professional | None | $229.09 | $281.84 | $416.87 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $23.99 Median $28.18 Typical High $281.84 | Professional | RR · Rental | $23.99 | $28.18 | $281.84 |
BCBS Kansas City Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $316.23 | Professional | None | $186.21 | $186.21 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $331.13 | Facility | None | $302.00 | $302.00 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $302.00 | Professional | None | $218.78 | $218.78 | $302.00 |
Cigna Setting Professional Modifier RR · Rental Typical Low $25.70 Median $25.70 Typical High $30.20 | Professional | RR · Rental | $25.70 | $25.70 | $30.20 |
Medica Setting Facility Modifier None Typical Low $177.83 Median $346.74 Typical High $1,348.96 | Facility | None | $177.83 | $346.74 | $1,348.96 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $245.47 Typical High $2,041.74 | Professional | None | $181.97 | $245.47 | $2,041.74 |
United Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
United Setting Professional Modifier None Typical Low $162.18 Median $239.88 Typical High $346.74 | Professional | None | $162.18 | $239.88 | $346.74 |
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 $83.18 Median $93.33 Typical High $107.15 | Professional | 52 · Reduced service | $83.18 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $37.15 Typical High $42.66 | Professional | 53 · Discontinued | $33.88 | $37.15 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $28.18 Typical High $32.36 | Professional | 55 · Aftercare only | $25.12 | $28.18 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $18.62 Typical High $21.38 | Professional | 56 · Pre-op care only | $16.60 | $18.62 | $21.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $162.18 Median $213.80 Typical High $354.81 | Professional | UE · Used equipment | $162.18 | $213.80 | $354.81 |
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· 36th of 51
$245
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.