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 $45.71 Median $45.71 Typical High $52.48 | Facility | None | $45.71 | $45.71 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $47.86 Typical High $53.70 | Professional | None | $45.71 | $47.86 | $53.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $407.38 | Facility | None | $89.13 | $89.13 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $51.29 Median $53.70 Typical High $72.44 | Professional | None | $51.29 | $53.70 | $72.44 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $38.02 Median $39.81 Typical High $63.10 | Professional | UE · Used equipment | $38.02 | $39.81 | $63.10 |
BCBS Kansas City Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $89.13 | Professional | None | $53.70 | $53.70 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $72.44 | Facility | None | $64.57 | $64.57 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $64.57 | Professional | None | $46.77 | $46.77 | $64.57 |
Medica Setting Facility Modifier None Typical Low $47.86 Median $89.13 Typical High $467.74 | Facility | None | $47.86 | $89.13 | $467.74 |
Medica Setting Professional Modifier None Typical Low $36.31 Median $43.65 Typical High $676.08 | Professional | None | $36.31 | $43.65 | $676.08 |
United Setting Facility Modifier None Typical Low $57.54 Median $60.26 Typical High $117.49 | Facility | None | $57.54 | $60.26 | $117.49 |
United Setting Professional Modifier None Typical Low $33.11 Median $43.65 Typical High $67.61 | Professional | None | $33.11 | $43.65 | $67.61 |
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 $22.91 Median $23.99 Typical High $26.92 | Professional | 52 · Reduced service | $22.91 | $23.99 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.55 Typical High $10.72 | Professional | 53 · Discontinued | $9.12 | $9.55 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $7.24 Typical High $7.94 | Professional | 55 · Aftercare only | $6.92 | $7.24 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.79 Typical High $5.37 | Professional | 56 · Pre-op care only | $4.57 | $4.79 | $5.37 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.25 Median $5.25 Typical High $53.70 | Professional | RR · Rental | $5.25 | $5.25 | $53.70 |
Where Missouri sits
The same service costs 3.5 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· 41st of 51
$52.48
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.