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 $870.96 Median $870.96 Typical High $1,000.00 | Facility | None | $870.96 | $870.96 | $1,000.00 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $912.01 Typical High $1,000.00 | Professional | None | $870.96 | $912.01 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $7,943.28 | Facility | None | $1,698.24 | $1,698.24 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,380.38 | Professional | None | $812.83 | $977.24 | $1,380.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $602.56 Median $602.56 Typical High $1,174.90 | Professional | UE · Used equipment | $602.56 | $602.56 | $1,174.90 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,698.24 | Professional | None | $1,023.29 | $1,023.29 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $912.01 | Facility | None | $851.14 | $851.14 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $851.14 | Professional | None | $630.96 | $630.96 | $851.14 |
Medica Setting Facility Modifier None Typical Low $776.25 Median $1,659.59 Typical High $7,413.10 | Facility | None | $776.25 | $1,659.59 | $7,413.10 |
Medica Setting Professional Modifier None Typical Low $575.44 Median $831.76 Typical High $12,882.50 | Professional | None | $575.44 | $831.76 | $12,882.50 |
United Setting Facility Modifier None Typical Low $912.01 Median $1,318.26 Typical High $1,862.09 | Facility | None | $912.01 | $1,318.26 | $1,862.09 |
United Setting Professional Modifier None Typical Low $562.34 Median $794.33 Typical High $1,230.27 | Professional | None | $562.34 | $794.33 | $1,230.27 |
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 $436.52 Median $457.09 Typical High $501.19 | Professional | 52 · Reduced service | $436.52 | $457.09 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $181.97 Typical High $199.53 | Professional | 53 · Discontinued | $173.78 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $138.04 Typical High $151.36 | Professional | 55 · Aftercare only | $131.83 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $91.20 Typical High $100.00 | Professional | 56 · Pre-op care only | $87.10 | $91.20 | $100.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $81.28 Median $81.28 Typical High $812.83 | Professional | RR · Rental | $81.28 | $81.28 | $812.83 |
Where Missouri sits
The same service costs 5.1 times more in Hawaii than in Delaware. 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· 26th of 51
$851
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.