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 $398.11 Median $398.11 Typical High $457.09 | Facility | None | $398.11 | $398.11 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $616.60 | Professional | None | $354.81 | $398.11 | $616.60 |
Ambetter Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $912.01 | Professional | None | $691.83 | $691.83 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $3,090.30 | Facility | None | $660.69 | $660.69 | $3,090.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $691.83 Typical High $912.01 | Professional | None | $512.86 | $691.83 | $912.01 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $354.81 Median $512.86 Typical High $758.58 | Professional | UE · Used equipment | $354.81 | $512.86 | $758.58 |
BCBS Kansas City Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $660.69 | Professional | None | $398.11 | $398.11 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $707.95 | Facility | None | $630.96 | $630.96 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $630.96 | Professional | None | $467.74 | $467.74 | $630.96 |
Medica Setting Facility Modifier None Typical Low $416.87 Median $776.25 Typical High $3,162.28 | Facility | None | $416.87 | $776.25 | $3,162.28 |
Medica Setting Professional Modifier None Typical Low $398.11 Median $537.03 Typical High $4,466.84 | Professional | None | $398.11 | $537.03 | $4,466.84 |
United Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
United Setting Professional Modifier None Typical Low $354.81 Median $524.81 Typical High $776.25 | Professional | None | $354.81 | $524.81 | $776.25 |
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 $177.83 Median $199.53 Typical High $229.09 | Professional | 52 · Reduced service | $177.83 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $79.43 Typical High $91.20 | Professional | 53 · Discontinued | $70.79 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $60.26 Typical High $69.18 | Professional | 55 · Aftercare only | $53.70 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $39.81 Typical High $45.71 | Professional | 56 · Pre-op care only | $35.48 | $39.81 | $45.71 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $58.88 Median $69.18 Typical High $691.83 | Professional | RR · Rental | $58.88 | $69.18 | $691.83 |
Where Missouri sits
The same service costs 2.2 times more in Kansas 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· 40th 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.