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 $131.83 Median $131.83 Typical High $151.36 | Facility | None | $131.83 | $131.83 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $131.83 Typical High $151.36 | Professional | None | $120.23 | $131.83 | $151.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $1,047.13 | Facility | None | $229.09 | $229.09 | $1,047.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $165.96 Median $204.17 Typical High $269.15 | Professional | None | $165.96 | $204.17 | $269.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $123.03 Median $147.91 Typical High $218.78 | Professional | UE · Used equipment | $123.03 | $147.91 | $218.78 |
BCBS Kansas City Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $229.09 | Professional | None | $134.90 | $134.90 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $239.88 | Facility | None | $213.80 | $213.80 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $213.80 | Professional | None | $158.49 | $158.49 | $213.80 |
Medica Setting Facility Modifier None Typical Low $131.83 Median $269.15 Typical High $1,096.48 | Facility | None | $131.83 | $269.15 | $1,096.48 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $165.96 Typical High $1,659.59 | Professional | None | $134.90 | $165.96 | $1,659.59 |
United Setting Facility Modifier None Typical Low $213.80 Median $234.42 Typical High $407.38 | Facility | None | $213.80 | $234.42 | $407.38 |
United Setting Professional Modifier None Typical Low $112.20 Median $162.18 Typical High $245.47 | Professional | None | $112.20 | $162.18 | $245.47 |
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 $60.26 Median $66.07 Typical High $75.86 | Professional | 52 · Reduced service | $60.26 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $26.30 Typical High $30.20 | Professional | 53 · Discontinued | $24.55 | $26.30 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $19.95 Typical High $22.91 | Professional | 55 · Aftercare only | $18.20 | $19.95 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $13.18 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.02 | $13.18 | $15.14 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $16.98 Median $19.95 Typical High $204.17 | Professional | RR · Rental | $16.98 | $19.95 | $204.17 |
Where Missouri sits
The same service costs 2.9 times more in Hawaii than in Utah. 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· 34th of 51
$191
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.