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 $77.62 Median $77.62 Typical High $89.13 | Facility | None | $77.62 | $77.62 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $83.18 Typical High $107.15 | Professional | None | $77.62 | $83.18 | $107.15 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $138.04 Typical High $165.96 | Professional | None | $114.82 | $138.04 | $165.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $707.95 | Facility | None | $151.36 | $151.36 | $707.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $93.33 Typical High $123.03 | Professional | None | $85.11 | $93.33 | $123.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $64.57 Median $66.07 Typical High $104.71 | Professional | UE · Used equipment | $64.57 | $66.07 | $104.71 |
BCBS Kansas City Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $151.36 | Professional | None | $91.20 | $91.20 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $97.72 Typical High $102.33 | Facility | None | $95.50 | $97.72 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $95.50 | Professional | None | $70.79 | $70.79 | $95.50 |
Medica Setting Facility Modifier None Typical Low $77.62 Median $158.49 Typical High $758.58 | Facility | None | $77.62 | $158.49 | $758.58 |
Medica Setting Professional Modifier None Typical Low $60.26 Median $74.13 Typical High $851.14 | Professional | None | $60.26 | $74.13 | $851.14 |
United Setting Facility Modifier None Typical Low $79.43 Median $89.13 Typical High $199.53 | Facility | None | $79.43 | $89.13 | $199.53 |
United Setting Professional Modifier None Typical Low $56.23 Median $74.13 Typical High $114.82 | Professional | None | $56.23 | $74.13 | $114.82 |
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 $38.90 Median $40.74 Typical High $44.67 | Professional | 52 · Reduced service | $38.90 | $40.74 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $16.60 Typical High $17.78 | Professional | 53 · Discontinued | $15.49 | $16.60 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.30 Typical High $13.49 | Professional | 55 · Aftercare only | $11.75 | $12.30 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.32 Typical High $8.91 | Professional | 56 · Pre-op care only | $7.76 | $8.32 | $8.91 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.91 Median $8.91 Typical High $91.20 | Professional | RR · Rental | $8.91 | $8.91 | $91.20 |
Where Missouri sits
The same service costs 2.8 times more in Hawaii than in Florida. 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· 31st of 51
$91.20
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.