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 $112.20 Median $112.20 Typical High $128.82 | Facility | None | $112.20 | $112.20 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $117.49 Typical High $128.82 | Professional | None | $112.20 | $117.49 | $128.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $1,023.29 | Facility | None | $218.78 | $218.78 | $1,023.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $131.83 Typical High $177.83 | Professional | None | $117.49 | $131.83 | $177.83 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $85.11 Median $91.20 Typical High $151.36 | Professional | UE · Used equipment | $85.11 | $91.20 | $151.36 |
BCBS Kansas City Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $218.78 | Professional | None | $131.83 | $131.83 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $151.36 | Facility | None | $134.90 | $134.90 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $134.90 | Professional | None | $100.00 | $100.00 | $134.90 |
Medica Setting Facility Modifier None Typical Low $112.20 Median $213.80 Typical High $1,071.52 | Facility | None | $112.20 | $213.80 | $1,071.52 |
Medica Setting Professional Modifier None Typical Low $83.18 Median $107.15 Typical High $1,258.93 | Professional | None | $83.18 | $107.15 | $1,258.93 |
United Setting Facility Modifier None Typical Low $63.10 Median $128.82 Typical High $275.42 | Facility | None | $63.10 | $128.82 | $275.42 |
United Setting Professional Modifier None Typical Low $77.62 Median $107.15 Typical High $162.18 | Professional | None | $77.62 | $107.15 | $162.18 |
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 $56.23 Median $58.88 Typical High $64.57 | Professional | 52 · Reduced service | $56.23 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $23.44 Typical High $25.70 | Professional | 53 · Discontinued | $22.39 | $23.44 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $17.78 Typical High $19.50 | Professional | 55 · Aftercare only | $16.98 | $17.78 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.75 Typical High $12.88 | Professional | 56 · Pre-op care only | $11.22 | $11.75 | $12.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.30 Median $12.30 Typical High $123.03 | Professional | RR · Rental | $12.30 | $12.30 | $123.03 |
Where Missouri sits
The same service costs 3.9 times more in Kansas than in New Jersey. 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
$123
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.