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 $104.71 Median $104.71 Typical High $120.23 | Facility | None | $104.71 | $104.71 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $109.65 Typical High $123.03 | Professional | None | $104.71 | $109.65 | $123.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $933.25 | Facility | None | $204.17 | $204.17 | $933.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $123.03 Typical High $162.18 | Professional | None | $117.49 | $123.03 | $162.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $87.10 Median $89.13 Typical High $141.25 | Professional | UE · Used equipment | $87.10 | $89.13 | $141.25 |
BCBS Kansas City Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $204.17 | Professional | None | $123.03 | $123.03 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $154.88 | Facility | None | $144.54 | $144.54 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $144.54 | Professional | None | $104.71 | $104.71 | $144.54 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $199.53 Typical High $1,071.52 | Facility | None | $104.71 | $199.53 | $1,071.52 |
Medica Setting Professional Modifier None Typical Low $83.18 Median $100.00 Typical High $1,288.25 | Professional | None | $83.18 | $100.00 | $1,288.25 |
United Setting Facility Modifier None Typical Low $87.10 Median $100.00 Typical High $269.15 | Facility | None | $87.10 | $100.00 | $269.15 |
United Setting Professional Modifier None Typical Low $75.86 Median $100.00 Typical High $154.88 | Professional | None | $75.86 | $100.00 | $154.88 |
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 $52.48 Median $54.95 Typical High $61.66 | Professional | 52 · Reduced service | $52.48 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $21.88 Typical High $24.55 | Professional | 53 · Discontinued | $20.89 | $21.88 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.60 Typical High $18.20 | Professional | 55 · Aftercare only | $15.85 | $16.60 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.96 Typical High $12.30 | Professional | 56 · Pre-op care only | $10.47 | $10.96 | $12.30 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.02 Median $12.02 Typical High $120.23 | Professional | RR · Rental | $12.02 | $12.02 | $120.23 |
Where Missouri sits
The same service costs 2.5 times more in Montana than in Florida. 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· 40th of 51
$120
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.