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 $57.54 Median $57.54 Typical High $66.07 | Facility | None | $57.54 | $57.54 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $61.66 Typical High $67.61 | Professional | None | $57.54 | $61.66 | $67.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $524.81 | Facility | None | $112.20 | $112.20 | $524.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $69.18 Typical High $91.20 | Professional | None | $63.10 | $69.18 | $91.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $47.86 Median $47.86 Typical High $77.62 | Professional | UE · Used equipment | $47.86 | $47.86 | $77.62 |
BCBS Kansas City Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $112.20 | Professional | None | $67.61 | $67.61 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $83.18 | Facility | None | $75.86 | $75.86 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $75.86 | Professional | None | $54.95 | $54.95 | $75.86 |
Medica Setting Facility Modifier None Typical Low $57.54 Median $109.65 Typical High $562.34 | Facility | None | $57.54 | $109.65 | $562.34 |
Medica Setting Professional Modifier None Typical Low $44.67 Median $54.95 Typical High $691.83 | Professional | None | $44.67 | $54.95 | $691.83 |
United Setting Facility Modifier None Typical Low $69.18 Median $72.44 Typical High $147.91 | Facility | None | $69.18 | $72.44 | $147.91 |
United Setting Professional Modifier None Typical Low $41.69 Median $54.95 Typical High $85.11 | Professional | None | $41.69 | $54.95 | $85.11 |
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 $28.84 Median $30.20 Typical High $33.88 | Professional | 52 · Reduced service | $28.84 | $30.20 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $12.30 Typical High $13.49 | Professional | 53 · Discontinued | $11.48 | $12.30 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $9.12 Typical High $10.00 | Professional | 55 · Aftercare only | $8.71 | $9.12 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.17 Typical High $6.76 | Professional | 56 · Pre-op care only | $5.75 | $6.17 | $6.76 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.46 Median $6.46 Typical High $66.07 | Professional | RR · Rental | $6.46 | $6.46 | $66.07 |
Where Missouri sits
The same service costs 3.1 times more in Hawaii 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· 35th of 51
$66.07
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.