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 $144.54 Median $144.54 Typical High $165.96 | Facility | None | $144.54 | $144.54 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $151.36 Typical High $165.96 | Professional | None | $144.54 | $151.36 | $165.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $1,288.25 | Facility | None | $281.84 | $281.84 | $1,288.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $151.36 Median $169.82 Typical High $223.87 | Professional | None | $151.36 | $169.82 | $223.87 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $114.82 Median $117.49 Typical High $190.55 | Professional | UE · Used equipment | $114.82 | $117.49 | $190.55 |
BCBS Kansas City Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $281.84 | Professional | None | $169.82 | $169.82 | $281.84 |
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 $144.54 Median $275.42 Typical High $1,348.96 | Facility | None | $144.54 | $275.42 | $1,348.96 |
Medica Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $1,479.11 | Professional | None | $109.65 | $138.04 | $1,479.11 |
United Setting Facility Modifier None Typical Low $147.91 Median $151.36 Typical High $354.81 | Facility | None | $147.91 | $151.36 | $354.81 |
United Setting Professional Modifier None Typical Low $100.00 Median $138.04 Typical High $208.93 | Professional | None | $100.00 | $138.04 | $208.93 |
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 $72.44 Median $75.86 Typical High $83.18 | Professional | 52 · Reduced service | $72.44 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $30.20 Typical High $33.11 | Professional | 53 · Discontinued | $28.84 | $30.20 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $22.91 Typical High $24.55 | Professional | 55 · Aftercare only | $21.38 | $22.91 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $15.14 Typical High $16.60 | Professional | 56 · Pre-op care only | $14.45 | $15.14 | $16.60 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $15.85 Median $15.85 Typical High $162.18 | Professional | RR · Rental | $15.85 | $15.85 | $162.18 |
Where Missouri sits
The same service costs 2.3 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· 29th of 51
$162
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.