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 $165.96 Median $165.96 Typical High $190.55 | Facility | None | $165.96 | $165.96 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $173.78 Typical High $190.55 | Professional | None | $165.96 | $173.78 | $190.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $1,479.11 | Facility | None | $323.59 | $323.59 | $1,479.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $177.83 Median $194.98 Typical High $263.03 | Professional | None | $177.83 | $194.98 | $263.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $131.83 Median $138.04 Typical High $223.87 | Professional | UE · Used equipment | $131.83 | $138.04 | $223.87 |
BCBS Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $323.59 | Professional | None | $194.98 | $194.98 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $208.93 | Facility | None | $190.55 | $190.55 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | None | $138.04 | $138.04 | $190.55 |
Medica Setting Facility Modifier None Typical Low $169.82 Median $331.13 Typical High $1,584.89 | Facility | None | $169.82 | $331.13 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $158.49 Typical High $1,949.84 | Professional | None | $125.89 | $158.49 | $1,949.84 |
United Setting Facility Modifier None Typical Low $125.89 Median $173.78 Typical High $416.87 | Facility | None | $125.89 | $173.78 | $416.87 |
United Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $239.88 | Professional | None | $117.49 | $158.49 | $239.88 |
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 $83.18 Median $87.10 Typical High $95.50 | Professional | 52 · Reduced service | $83.18 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $34.67 Typical High $38.02 | Professional | 53 · Discontinued | $33.11 | $34.67 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $26.30 Typical High $28.18 | Professional | 55 · Aftercare only | $25.12 | $26.30 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $17.38 Typical High $19.05 | Professional | 56 · Pre-op care only | $16.60 | $17.38 | $19.05 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $18.62 Median $18.62 Typical High $186.21 | Professional | RR · Rental | $18.62 | $18.62 | $186.21 |
Where Missouri sits
The same service costs 2.7 times more in Hawaii 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· 38th of 51
$186
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.