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 $58.88 Median $58.88 Typical High $93.33 | Facility | None | $58.88 | $58.88 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $61.66 Typical High $74.13 | Professional | None | $58.88 | $61.66 | $74.13 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $154.88 | Professional | None | $131.83 | $131.83 | $154.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $537.03 | Facility | None | $114.82 | $114.82 | $537.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $70.79 Typical High $93.33 | Professional | None | $64.57 | $70.79 | $93.33 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $47.86 Median $51.29 Typical High $79.43 | Professional | UE · Used equipment | $47.86 | $51.29 | $79.43 |
BCBS Kansas City Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $114.82 | Professional | None | $69.18 | $69.18 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $89.13 Typical High $93.33 | Facility | None | $85.11 | $89.13 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $85.11 | Professional | None | $64.57 | $64.57 | $85.11 |
Medica Setting Facility Modifier None Typical Low $61.66 Median $120.23 Typical High $588.84 | Facility | None | $61.66 | $120.23 | $588.84 |
Medica Setting Professional Modifier None Typical Low $45.71 Median $56.23 Typical High $707.95 | Professional | None | $45.71 | $56.23 | $707.95 |
United Setting Facility Modifier None Typical Low $72.44 Median $75.86 Typical High $151.36 | Facility | None | $72.44 | $75.86 | $151.36 |
United Setting Professional Modifier None Typical Low $42.66 Median $56.23 Typical High $85.11 | Professional | None | $42.66 | $56.23 | $85.11 |
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 $29.51 Median $30.90 Typical High $34.67 | Professional | 52 · Reduced service | $29.51 | $30.90 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $12.30 Typical High $13.80 | Professional | 53 · Discontinued | $11.75 | $12.30 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.33 Typical High $10.23 | Professional | 55 · Aftercare only | $8.91 | $9.33 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.17 Typical High $6.92 | Professional | 56 · Pre-op care only | $5.89 | $6.17 | $6.92 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.76 Median $6.76 Typical High $69.18 | Professional | RR · Rental | $6.76 | $6.76 | $69.18 |
Where Missouri sits
The same service costs 2.8 times more in Hawaii than in Washington, DC. 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· 42nd of 51
$67.61
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.