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 $69.18 Median $69.18 Typical High $79.43 | Facility | None | $69.18 | $69.18 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $72.44 Typical High $81.28 | Professional | None | $69.18 | $72.44 | $81.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $630.96 | Facility | None | $134.90 | $134.90 | $630.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $81.28 Typical High $109.65 | Professional | None | $77.62 | $81.28 | $109.65 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $57.54 Median $58.88 Typical High $85.11 | Professional | UE · Used equipment | $57.54 | $58.88 | $85.11 |
BCBS Kansas City Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $134.90 | Professional | None | $81.28 | $81.28 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $114.82 | Facility | None | $102.33 | $102.33 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $102.33 | Professional | None | $75.86 | $75.86 | $102.33 |
Medica Setting Facility Modifier None Typical Low $69.18 Median $131.83 Typical High $707.95 | Facility | None | $69.18 | $131.83 | $707.95 |
Medica Setting Professional Modifier None Typical Low $54.95 Median $66.07 Typical High $891.25 | Professional | None | $54.95 | $66.07 | $891.25 |
United Setting Facility Modifier None Typical Low $75.86 Median $87.10 Typical High $177.83 | Facility | None | $75.86 | $87.10 | $177.83 |
United Setting Professional Modifier None Typical Low $50.12 Median $66.07 Typical High $102.33 | Professional | None | $50.12 | $66.07 | $102.33 |
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 $34.67 Median $36.31 Typical High $40.74 | Professional | 52 · Reduced service | $34.67 | $36.31 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $14.79 Typical High $16.22 | Professional | 53 · Discontinued | $13.80 | $14.79 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.96 Typical High $12.30 | Professional | 55 · Aftercare only | $10.47 | $10.96 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.24 Typical High $8.13 | Professional | 56 · Pre-op care only | $6.92 | $7.24 | $8.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.94 Median $7.94 Typical High $79.43 | Professional | RR · Rental | $7.94 | $7.94 | $79.43 |
Where Missouri sits
The same service costs 3.2 times more in Hawaii 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· 32nd of 51
$79.43
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.