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 $295.12 Median $295.12 Typical High $338.84 | Facility | None | $295.12 | $295.12 | $338.84 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $309.03 Typical High $346.74 | Professional | None | $295.12 | $309.03 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $489.78 | Professional | None | $426.58 | $426.58 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $2,630.27 | Facility | None | $575.44 | $575.44 | $2,630.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $234.42 Median $316.23 Typical High $457.09 | Professional | None | $234.42 | $316.23 | $457.09 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $199.53 Median $229.09 Typical High $398.11 | Professional | UE · Used equipment | $199.53 | $229.09 | $398.11 |
BCBS Kansas City Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $575.44 | Professional | None | $346.74 | $346.74 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $346.74 | Facility | None | $316.23 | $316.23 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | None | $229.09 | $229.09 | $316.23 |
Medica Setting Facility Modifier None Typical Low $295.12 Median $562.34 Typical High $2,630.27 | Facility | None | $295.12 | $562.34 | $2,630.27 |
Medica Setting Professional Modifier None Typical Low $208.93 Median $281.84 Typical High $2,818.38 | Professional | None | $208.93 | $281.84 | $2,818.38 |
United Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
United Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $426.58 | Professional | None | $194.98 | $281.84 | $426.58 |
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 $147.91 Median $154.88 Typical High $169.82 | Professional | 52 · Reduced service | $147.91 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $61.66 Typical High $67.61 | Professional | 53 · Discontinued | $58.88 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $46.77 Typical High $50.12 | Professional | 55 · Aftercare only | $43.65 | $46.77 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $30.90 Typical High $33.88 | Professional | 56 · Pre-op care only | $29.51 | $30.90 | $33.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $22.91 Median $22.91 Typical High $234.42 | Professional | RR · Rental | $22.91 | $22.91 | $234.42 |
Where Missouri sits
The same service costs 2.6 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· 35th of 51
$302
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.