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 $42.66 Median $42.66 Typical High $48.98 | Facility | None | $42.66 | $42.66 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $44.67 Typical High $50.12 | Professional | None | $42.66 | $44.67 | $50.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $380.19 | Facility | None | $83.18 | $83.18 | $380.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $50.12 Typical High $67.61 | Professional | None | $47.86 | $50.12 | $67.61 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $35.48 Median $37.15 Typical High $57.54 | Professional | UE · Used equipment | $35.48 | $37.15 | $57.54 |
BCBS Kansas City Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $83.18 | Professional | None | $50.12 | $50.12 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $67.61 | Facility | None | $61.66 | $61.66 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
Medica Setting Facility Modifier None Typical Low $44.67 Median $85.11 Typical High $436.52 | Facility | None | $44.67 | $85.11 | $436.52 |
Medica Setting Professional Modifier None Typical Low $33.88 Median $40.74 Typical High $457.09 | Professional | None | $33.88 | $40.74 | $457.09 |
United Setting Facility Modifier None Typical Low $41.69 Median $45.71 Typical High $109.65 | Facility | None | $41.69 | $45.71 | $109.65 |
United Setting Professional Modifier None Typical Low $30.90 Median $40.74 Typical High $63.10 | Professional | None | $30.90 | $40.74 | $63.10 |
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 $21.38 Median $22.39 Typical High $25.12 | Professional | 52 · Reduced service | $21.38 | $22.39 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.91 Typical High $10.00 | Professional | 53 · Discontinued | $8.51 | $8.91 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.76 Typical High $7.41 | Professional | 55 · Aftercare only | $6.46 | $6.76 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.47 Typical High $5.01 | Professional | 56 · Pre-op care only | $4.27 | $4.47 | $5.01 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.90 Median $4.90 Typical High $51.29 | Professional | RR · Rental | $4.90 | $4.90 | $51.29 |
Where Missouri sits
The same service costs 2.5 times more in Hawaii than in Arizona. 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· 44th of 51
$48.98
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.