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 $109.65 Median $109.65 Typical High $125.89 | Facility | None | $109.65 | $109.65 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $114.82 Typical High $125.89 | Professional | None | $109.65 | $114.82 | $125.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $977.24 | Facility | None | $213.80 | $213.80 | $977.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $109.65 Median $114.82 Typical High $194.98 | Professional | None | $109.65 | $114.82 | $194.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $83.18 Median $85.11 Typical High $147.91 | Professional | UE · Used equipment | $83.18 | $85.11 | $147.91 |
BCBS Kansas City Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $213.80 | Professional | None | $125.89 | $125.89 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $158.49 | Facility | None | $147.91 | $147.91 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $147.91 | Professional | None | $107.15 | $107.15 | $147.91 |
Medica Setting Facility Modifier None Typical Low $109.65 Median $208.93 Typical High $977.24 | Facility | None | $109.65 | $208.93 | $977.24 |
Medica Setting Professional Modifier None Typical Low $77.62 Median $104.71 Typical High $1,047.13 | Professional | None | $77.62 | $104.71 | $1,047.13 |
United Setting Facility Modifier None Typical Low $102.33 Median $257.04 Typical High $257.04 | Facility | None | $102.33 | $257.04 | $257.04 |
United Setting Professional Modifier None Typical Low $72.44 Median $104.71 Typical High $158.49 | Professional | None | $72.44 | $104.71 | $158.49 |
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 $54.95 Median $57.54 Typical High $61.66 | Professional | 52 · Reduced service | $54.95 | $57.54 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $22.91 Typical High $25.12 | Professional | 53 · Discontinued | $21.88 | $22.91 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.98 Typical High $18.62 | Professional | 55 · Aftercare only | $16.22 | $16.98 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.48 Typical High $12.59 | Professional | 56 · Pre-op care only | $10.96 | $11.48 | $12.59 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.48 Median $11.48 Typical High $114.82 | Professional | RR · Rental | $11.48 | $11.48 | $114.82 |
Where Missouri sits
The same service costs 5.4 times more in Kansas than in West Virginia. 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
$115
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.