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 $204.17 Median $204.17 Typical High $234.42 | Facility | None | $204.17 | $204.17 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $218.78 Typical High $239.88 | Professional | None | $204.17 | $218.78 | $239.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $1,862.09 | Facility | None | $398.11 | $398.11 | $1,862.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $245.47 Typical High $323.59 | Professional | None | $229.09 | $245.47 | $323.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $173.78 Median $181.97 Typical High $275.42 | Professional | UE · Used equipment | $173.78 | $181.97 | $275.42 |
BCBS Kansas City Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $398.11 | Professional | None | $239.88 | $239.88 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $275.42 | Facility | None | $245.47 | $245.47 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $407.38 Typical High $2,089.30 | Facility | None | $204.17 | $407.38 | $2,089.30 |
Medica Setting Professional Modifier None Typical Low $162.18 Median $194.98 Typical High $2,511.89 | Professional | None | $162.18 | $194.98 | $2,511.89 |
United Setting Facility Modifier None Typical Low $147.91 Median $204.17 Typical High $537.03 | Facility | None | $147.91 | $204.17 | $537.03 |
United Setting Professional Modifier None Typical Low $151.36 Median $194.98 Typical High $302.00 | Professional | None | $151.36 | $194.98 | $302.00 |
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 $102.33 Median $107.15 Typical High $120.23 | Professional | 52 · Reduced service | $102.33 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $43.65 Typical High $47.86 | Professional | 53 · Discontinued | $41.69 | $43.65 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $32.36 Typical High $36.31 | Professional | 55 · Aftercare only | $30.90 | $32.36 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $21.88 Typical High $23.99 | Professional | 56 · Pre-op care only | $20.42 | $21.88 | $23.99 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $23.99 Median $23.99 Typical High $239.88 | Professional | RR · Rental | $23.99 | $23.99 | $239.88 |
Where Missouri sits
The same service costs 2.9 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· 38th of 51
$240
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.