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 $363.08 Median $363.08 Typical High $416.87 | Facility | None | $363.08 | $363.08 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $380.19 Typical High $416.87 | Professional | None | $363.08 | $380.19 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $3,235.94 | Facility | None | $707.95 | $707.95 | $3,235.94 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $602.56 | Professional | None | $323.59 | $389.05 | $602.56 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $295.12 Median $302.00 Typical High $537.03 | Professional | UE · Used equipment | $295.12 | $302.00 | $537.03 |
BCBS Kansas City Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $707.95 | Professional | None | $426.58 | $426.58 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $467.74 | Facility | None | $436.52 | $436.52 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $436.52 | Professional | None | $316.23 | $316.23 | $436.52 |
Medica Setting Facility Modifier None Typical Low $371.54 Median $691.83 Typical High $3,235.94 | Facility | None | $371.54 | $691.83 | $3,235.94 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $3,467.37 | Professional | None | $257.04 | $346.74 | $3,467.37 |
United Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
United Setting Professional Modifier None Typical Low $239.88 Median $346.74 Typical High $524.81 | Professional | None | $239.88 | $346.74 | $524.81 |
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 $181.97 Median $190.55 Typical High $208.93 | Professional | 52 · Reduced service | $181.97 | $190.55 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $75.86 Typical High $83.18 | Professional | 53 · Discontinued | $72.44 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $57.54 Typical High $61.66 | Professional | 55 · Aftercare only | $53.70 | $57.54 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $38.02 Typical High $41.69 | Professional | 56 · Pre-op care only | $36.31 | $38.02 | $41.69 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $38.90 Median $38.90 Typical High $389.05 | Professional | RR · Rental | $38.90 | $38.90 | $389.05 |
Where Missouri sits
The same service costs 2.3 times more in Montana than in Delaware. 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· 37th of 51
$389
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.