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 $281.84 Median $281.84 Typical High $316.23 | Facility | None | $281.84 | $281.84 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $295.12 Typical High $323.59 | Professional | None | $281.84 | $295.12 | $323.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $2,511.89 | Facility | None | $537.03 | $537.03 | $2,511.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $436.52 | Professional | None | $302.00 | $331.13 | $436.52 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $223.87 Median $239.88 Typical High $371.54 | Professional | UE · Used equipment | $223.87 | $239.88 | $371.54 |
BCBS Kansas City Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $537.03 | Professional | None | $323.59 | $323.59 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $363.08 | Facility | None | $331.13 | $331.13 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $331.13 | Professional | None | $239.88 | $239.88 | $331.13 |
Medica Setting Facility Modifier None Typical Low $281.84 Median $537.03 Typical High $2,754.23 | Facility | None | $281.84 | $537.03 | $2,754.23 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $263.03 Typical High $3,981.07 | Professional | None | $218.78 | $263.03 | $3,981.07 |
United Setting Facility Modifier None Typical Low $354.81 Median $363.08 Typical High $724.44 | Facility | None | $354.81 | $363.08 | $724.44 |
United Setting Professional Modifier None Typical Low $204.17 Median $263.03 Typical High $407.38 | Professional | None | $204.17 | $263.03 | $407.38 |
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 $138.04 Median $147.91 Typical High $158.49 | Professional | 52 · Reduced service | $138.04 | $147.91 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $58.88 Typical High $64.57 | Professional | 53 · Discontinued | $56.23 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $43.65 Typical High $47.86 | Professional | 55 · Aftercare only | $41.69 | $43.65 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $29.51 Typical High $31.62 | Professional | 56 · Pre-op care only | $28.18 | $29.51 | $31.62 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $32.36 Median $32.36 Typical High $323.59 | Professional | RR · Rental | $32.36 | $32.36 | $323.59 |
Where Missouri sits
The same service costs 4.1 times more in Hawaii than in Florida. 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
$324
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.