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 $537.03 Median $537.03 Typical High $616.60 | Facility | None | $537.03 | $537.03 | $616.60 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $562.34 Typical High $758.58 | Professional | None | $537.03 | $562.34 | $758.58 |
Ambetter Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $4,786.30 | Facility | None | $1,047.13 | $1,047.13 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $630.96 Typical High $851.14 | Professional | None | $602.56 | $630.96 | $851.14 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $436.52 Median $457.09 Typical High $707.95 | Professional | UE · Used equipment | $436.52 | $457.09 | $707.95 |
BCBS Kansas City Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $1,047.13 | Professional | None | $630.96 | $630.96 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $776.25 | Facility | None | $707.95 | $707.95 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $707.95 | Professional | None | $512.86 | $512.86 | $707.95 |
Medica Setting Facility Modifier None Typical Low $537.03 Median $1,023.29 Typical High $5,495.41 | Facility | None | $537.03 | $1,023.29 | $5,495.41 |
Medica Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $6,918.31 | Professional | None | $426.58 | $512.86 | $6,918.31 |
United Setting Facility Modifier None Typical Low $478.63 Median $691.83 Typical High $1,412.54 | Facility | None | $478.63 | $691.83 | $1,412.54 |
United Setting Professional Modifier None Typical Low $389.05 Median $512.86 Typical High $794.33 | Professional | None | $389.05 | $512.86 | $794.33 |
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 $269.15 Median $281.84 Typical High $309.03 | Professional | 52 · Reduced service | $269.15 | $281.84 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $112.20 Typical High $123.03 | Professional | 53 · Discontinued | $107.15 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $85.11 Typical High $93.33 | Professional | 55 · Aftercare only | $81.28 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $56.23 Typical High $61.66 | Professional | 56 · Pre-op care only | $53.70 | $56.23 | $61.66 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $61.66 Median $61.66 Typical High $616.60 | Professional | RR · Rental | $61.66 | $61.66 | $616.60 |
Where Missouri sits
The same service costs 3.4 times more in Hawaii than in Mississippi. 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· 38th of 51
$617
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.