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 $501.19 Median $501.19 Typical High $575.44 | Facility | None | $501.19 | $501.19 | $575.44 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $524.81 Typical High $575.44 | Professional | None | $489.78 | $524.81 | $575.44 |
Ambetter Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $4,466.84 | Facility | None | $977.24 | $977.24 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $794.33 | Professional | None | $467.74 | $588.84 | $794.33 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $354.81 Median $407.38 Typical High $676.08 | Professional | UE · Used equipment | $354.81 | $407.38 | $676.08 |
BCBS Kansas City Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $977.24 | Professional | None | $588.84 | $588.84 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $660.69 | Facility | None | $549.54 | $549.54 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $549.54 | Professional | None | $398.11 | $398.11 | $549.54 |
Medica Setting Facility Modifier None Typical Low $446.68 Median $933.25 Typical High $4,265.80 | Facility | None | $446.68 | $933.25 | $4,265.80 |
Medica Setting Professional Modifier None Typical Low $331.13 Median $478.63 Typical High $5,128.61 | Professional | None | $331.13 | $478.63 | $5,128.61 |
United Setting Facility Modifier None Typical Low $331.13 Median $436.52 Typical High $1,096.48 | Facility | None | $331.13 | $436.52 | $1,096.48 |
United Setting Professional Modifier None Typical Low $316.23 Median $467.74 Typical High $707.95 | Professional | None | $316.23 | $467.74 | $707.95 |
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 $251.19 Median $263.03 Typical High $288.40 | Professional | 52 · Reduced service | $251.19 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $104.71 Typical High $114.82 | Professional | 53 · Discontinued | $100.00 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $79.43 Typical High $87.10 | Professional | 55 · Aftercare only | $75.86 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $52.48 Typical High $57.54 | Professional | 56 · Pre-op care only | $50.12 | $52.48 | $57.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $53.70 Median $53.70 Typical High $549.54 | Professional | RR · Rental | $53.70 | $53.70 | $549.54 |
Where Missouri sits
The same service costs 2.4 times more in Iowa 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· 25th of 51
$550
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.