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 $489.78 Median $489.78 Typical High $562.34 | Facility | None | $489.78 | $489.78 | $562.34 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $524.81 Typical High $562.34 | Professional | None | $489.78 | $524.81 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $4,466.84 | Facility | None | $954.99 | $954.99 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $776.25 | Professional | None | $512.86 | $562.34 | $776.25 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $380.19 Median $398.11 Typical High $660.69 | Professional | UE · Used equipment | $380.19 | $398.11 | $660.69 |
BCBS Kansas City Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $954.99 | Professional | None | $575.44 | $575.44 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $602.56 | Facility | None | $562.34 | $562.34 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $562.34 | Professional | None | $416.87 | $416.87 | $562.34 |
Medica Setting Facility Modifier None Typical Low $489.78 Median $933.25 Typical High $4,677.35 | Facility | None | $489.78 | $933.25 | $4,677.35 |
Medica Setting Professional Modifier None Typical Low $363.08 Median $467.74 Typical High $5,248.07 | Professional | None | $363.08 | $467.74 | $5,248.07 |
United Setting Facility Modifier None Typical Low $549.54 Median $660.69 Typical High $1,202.26 | Facility | None | $549.54 | $660.69 | $1,202.26 |
United Setting Professional Modifier None Typical Low $338.84 Median $467.74 Typical High $691.83 | Professional | None | $338.84 | $467.74 | $691.83 |
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 $245.47 Median $257.04 Typical High $281.84 | Professional | 52 · Reduced service | $245.47 | $257.04 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $104.71 Typical High $112.20 | Professional | 53 · Discontinued | $100.00 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $77.62 Typical High $85.11 | Professional | 55 · Aftercare only | $74.13 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $52.48 Typical High $56.23 | Professional | 56 · Pre-op care only | $48.98 | $52.48 | $56.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $52.48 Median $52.48 Typical High $537.03 | Professional | RR · Rental | $52.48 | $52.48 | $537.03 |
Where Missouri sits
The same service costs 3.6 times more in Hawaii than in Kansas. 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· 30th of 51
$537
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.