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 $154.88 Median $154.88 Typical High $177.83 | Facility | None | $154.88 | $154.88 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $162.18 Typical High $177.83 | Professional | None | $154.88 | $162.18 | $177.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $1,380.38 | Facility | None | $302.00 | $302.00 | $1,380.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $181.97 Typical High $239.88 | Professional | None | $169.82 | $181.97 | $239.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $125.89 Median $131.83 Typical High $208.93 | Professional | UE · Used equipment | $125.89 | $131.83 | $208.93 |
BCBS Kansas City Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $302.00 | Professional | None | $181.97 | $181.97 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $213.80 | Facility | None | $190.55 | $190.55 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | None | $138.04 | $138.04 | $190.55 |
Medica Setting Facility Modifier None Typical Low $154.88 Median $295.12 Typical High $1,548.82 | Facility | None | $154.88 | $295.12 | $1,548.82 |
Medica Setting Professional Modifier None Typical Low $123.03 Median $147.91 Typical High $1,949.84 | Professional | None | $123.03 | $147.91 | $1,949.84 |
United Setting Facility Modifier None Typical Low $190.55 Median $194.98 Typical High $398.11 | Facility | None | $190.55 | $194.98 | $398.11 |
United Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $223.87 | Professional | None | $112.20 | $147.91 | $223.87 |
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 $77.62 Median $81.28 Typical High $89.13 | Professional | 52 · Reduced service | $77.62 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $32.36 Typical High $35.48 | Professional | 53 · Discontinued | $30.90 | $32.36 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $24.55 Typical High $26.30 | Professional | 55 · Aftercare only | $22.91 | $24.55 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $16.22 Typical High $17.78 | Professional | 56 · Pre-op care only | $15.49 | $16.22 | $17.78 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $17.78 Median $17.78 Typical High $181.97 | Professional | RR · Rental | $17.78 | $17.78 | $181.97 |
Where Missouri sits
The same service costs 3.5 times more in Hawaii than in Florida. 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
$178
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.