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 $549.54 Median $549.54 Typical High $630.96 | Facility | None | $549.54 | $549.54 | $630.96 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $588.84 Typical High $630.96 | Professional | None | $549.54 | $588.84 | $630.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $5,011.87 | Facility | None | $1,071.52 | $1,071.52 | $5,011.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $870.96 | Professional | None | $602.56 | $660.69 | $870.96 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $446.68 Median $489.78 Typical High $741.31 | Professional | UE · Used equipment | $446.68 | $489.78 | $741.31 |
BCBS Kansas City Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,071.52 | Professional | None | $645.65 | $645.65 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $776.25 | Facility | None | $741.31 | $741.31 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $741.31 | Professional | None | $537.03 | $537.03 | $741.31 |
Medica Setting Facility Modifier None Typical Low $562.34 Median $1,071.52 Typical High $5,495.41 | Facility | None | $562.34 | $1,071.52 | $5,495.41 |
Medica Setting Professional Modifier None Typical Low $426.58 Median $524.81 Typical High $6,606.93 | Professional | None | $426.58 | $524.81 | $6,606.93 |
United Setting Facility Modifier None Typical Low $645.65 Median $691.83 Typical High $1,412.54 | Facility | None | $645.65 | $691.83 | $1,412.54 |
United Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $812.83 | Professional | None | $398.11 | $524.81 | $812.83 |
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 $275.42 Median $295.12 Typical High $316.23 | Professional | 52 · Reduced service | $275.42 | $295.12 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $117.49 Typical High $125.89 | Professional | 53 · Discontinued | $112.20 | $117.49 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $87.10 Typical High $95.50 | Professional | 55 · Aftercare only | $83.18 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $58.88 Typical High $63.10 | Professional | 56 · Pre-op care only | $54.95 | $58.88 | $63.10 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $66.07 Median $66.07 Typical High $660.69 | Professional | RR · Rental | $66.07 | $66.07 | $660.69 |
Where Missouri sits
The same service costs 3.0 times more in Hawaii than in Vermont. 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· 35th of 51
$646
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.