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 $323.59 Median $323.59 Typical High $371.54 | Facility | None | $323.59 | $323.59 | $371.54 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $346.74 Typical High $398.11 | Professional | None | $323.59 | $346.74 | $398.11 |
Ambetter Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $575.44 | Professional | None | $426.58 | $426.58 | $575.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $2,951.21 | Facility | None | $630.96 | $630.96 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $389.05 Typical High $512.86 | Professional | None | $363.08 | $389.05 | $512.86 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $275.42 Median $281.84 Typical High $436.52 | Professional | UE · Used equipment | $275.42 | $281.84 | $436.52 |
BCBS Kansas City Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $630.96 | Professional | None | $380.19 | $380.19 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $645.65 | Facility | None | $524.81 | $524.81 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $524.81 | Professional | None | $380.19 | $380.19 | $524.81 |
Medica Setting Facility Modifier None Typical Low $323.59 Median $630.96 Typical High $3,388.44 | Facility | None | $323.59 | $630.96 | $3,388.44 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $309.03 Typical High $3,981.07 | Professional | None | $257.04 | $309.03 | $3,981.07 |
United Setting Facility Modifier None Typical Low $389.05 Median $416.87 Typical High $851.14 | Facility | None | $389.05 | $416.87 | $851.14 |
United Setting Professional Modifier None Typical Low $239.88 Median $309.03 Typical High $478.63 | Professional | None | $239.88 | $309.03 | $478.63 |
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 $162.18 Median $169.82 Typical High $190.55 | Professional | 52 · Reduced service | $162.18 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $69.18 Typical High $75.86 | Professional | 53 · Discontinued | $66.07 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $51.29 Typical High $57.54 | Professional | 55 · Aftercare only | $48.98 | $51.29 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $34.67 Typical High $38.02 | Professional | 56 · Pre-op care only | $32.36 | $34.67 | $38.02 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $38.02 Median $38.02 Typical High $389.05 | Professional | RR · Rental | $38.02 | $38.02 | $389.05 |
Where Missouri sits
The same service costs 2.8 times more in Hawaii than in Maryland. 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
$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.