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 $51.29 Median $51.29 Typical High $58.88 | Facility | None | $51.29 | $51.29 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $53.70 Typical High $64.57 | Professional | None | $51.29 | $53.70 | $64.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $457.09 | Facility | None | $100.00 | $100.00 | $457.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $57.54 Median $60.26 Typical High $79.43 | Professional | None | $57.54 | $60.26 | $79.43 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $41.69 Median $44.67 Typical High $69.18 | Professional | UE · Used equipment | $41.69 | $44.67 | $69.18 |
BCBS Kansas City Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $100.00 | Professional | None | $60.26 | $60.26 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $93.33 | Facility | None | $83.18 | $83.18 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $83.18 | Professional | None | $61.66 | $61.66 | $83.18 |
Medica Setting Facility Modifier None Typical Low $52.48 Median $104.71 Typical High $524.81 | Facility | None | $52.48 | $104.71 | $524.81 |
Medica Setting Professional Modifier None Typical Low $40.74 Median $48.98 Typical High $741.31 | Professional | None | $40.74 | $48.98 | $741.31 |
United Setting Facility Modifier None Typical Low $64.57 Median $72.44 Typical High $131.83 | Facility | None | $64.57 | $72.44 | $131.83 |
United Setting Professional Modifier None Typical Low $37.15 Median $48.98 Typical High $74.13 | Professional | None | $37.15 | $48.98 | $74.13 |
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 $25.70 Median $26.92 Typical High $29.51 | Professional | 52 · Reduced service | $25.70 | $26.92 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.72 Typical High $12.02 | Professional | 53 · Discontinued | $10.23 | $10.72 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.94 Typical High $8.91 | Professional | 55 · Aftercare only | $7.59 | $7.94 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.37 Typical High $6.03 | Professional | 56 · Pre-op care only | $5.13 | $5.37 | $6.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.03 Median $6.03 Typical High $60.26 | Professional | RR · Rental | $6.03 | $6.03 | $60.26 |
Where Missouri sits
The same service costs 3.5 times more in Hawaii than in Washington, DC. 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· 46th of 51
$60.26
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.