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 $354.81 Median $354.81 Typical High $407.38 | Facility | None | $354.81 | $354.81 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $371.54 Typical High $416.87 | Professional | None | $354.81 | $371.54 | $416.87 |
Ambetter Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $3,162.28 | Facility | None | $691.83 | $691.83 | $3,162.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $389.05 Typical High $549.54 | Professional | None | $354.81 | $389.05 | $549.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $263.03 Median $295.12 Typical High $478.63 | Professional | UE · Used equipment | $263.03 | $295.12 | $478.63 |
BCBS Kansas City Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $691.83 | Professional | None | $416.87 | $416.87 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $512.86 | Facility | None | $416.87 | $416.87 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $416.87 | Professional | None | $309.03 | $309.03 | $416.87 |
Medica Setting Facility Modifier None Typical Low $354.81 Median $676.08 Typical High $3,162.28 | Facility | None | $354.81 | $676.08 | $3,162.28 |
Medica Setting Professional Modifier None Typical Low $251.19 Median $338.84 Typical High $3,388.44 | Professional | None | $251.19 | $338.84 | $3,388.44 |
United Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Facility | None | $831.76 | $831.76 | $831.76 |
United Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $512.86 | Professional | None | $234.42 | $338.84 | $512.86 |
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 $186.21 Typical High $204.17 | Professional | 52 · Reduced service | $177.83 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $74.13 Typical High $81.28 | Professional | 53 · Discontinued | $70.79 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $56.23 Typical High $60.26 | Professional | 55 · Aftercare only | $52.48 | $56.23 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $37.15 Typical High $40.74 | Professional | 56 · Pre-op care only | $35.48 | $37.15 | $40.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $39.81 Median $39.81 Typical High $407.38 | Professional | RR · Rental | $39.81 | $39.81 | $407.38 |
Where Missouri sits
The same service costs 2.2 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· 36th of 51
$380
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.