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 $162.18 Median $162.18 Typical High $186.21 | Facility | None | $162.18 | $162.18 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $169.82 Typical High $186.21 | Professional | None | $162.18 | $169.82 | $186.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $1,479.11 | Facility | None | $316.23 | $316.23 | $1,479.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $194.98 Typical High $257.04 | Professional | None | $128.82 | $194.98 | $257.04 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $93.33 Median $120.23 Typical High $218.78 | Professional | UE · Used equipment | $93.33 | $120.23 | $218.78 |
BCBS Kansas City Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $316.23 | Professional | None | $190.55 | $190.55 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $190.55 | Facility | None | $177.83 | $177.83 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $177.83 | Professional | None | $128.82 | $128.82 | $177.83 |
Medica Setting Facility Modifier None Typical Low $158.49 Median $309.03 Typical High $1,412.54 | Facility | None | $158.49 | $309.03 | $1,412.54 |
Medica Setting Professional Modifier None Typical Low $109.65 Median $154.88 Typical High $1,862.09 | Professional | None | $109.65 | $154.88 | $1,862.09 |
United Setting Facility Modifier None Typical Low $177.83 Median $186.21 Typical High $363.08 | Facility | None | $177.83 | $186.21 | $363.08 |
United Setting Professional Modifier None Typical Low $104.71 Median $151.36 Typical High $239.88 | Professional | None | $104.71 | $151.36 | $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 $81.28 Median $85.11 Typical High $93.33 | Professional | 52 · Reduced service | $81.28 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $33.88 Typical High $37.15 | Professional | 53 · Discontinued | $32.36 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $25.70 Typical High $28.18 | Professional | 55 · Aftercare only | $24.55 | $25.70 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.98 Typical High $18.62 | Professional | 56 · Pre-op care only | $16.22 | $16.98 | $18.62 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.59 Median $12.59 Typical High $128.82 | Professional | RR · Rental | $12.59 | $12.59 | $128.82 |
Where Missouri sits
The same service costs 3.5 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· 30th of 51
$166
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.