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 $64.57 Median $64.57 Typical High $74.13 | Facility | None | $64.57 | $64.57 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $67.61 Typical High $74.13 | Professional | None | $64.57 | $67.61 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $588.84 | Facility | None | $125.89 | $125.89 | $588.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $77.62 Typical High $102.33 | Professional | None | $60.26 | $77.62 | $102.33 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $45.71 Median $52.48 Typical High $79.43 | Professional | UE · Used equipment | $45.71 | $52.48 | $79.43 |
BCBS Kansas City Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $125.89 | Professional | None | $75.86 | $75.86 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $70.79 | Facility | None | $64.57 | $64.57 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $64.57 | Professional | None | $46.77 | $46.77 | $64.57 |
Medica Setting Facility Modifier None Typical Low $61.66 Median $123.03 Typical High $549.54 | Facility | None | $61.66 | $123.03 | $549.54 |
Medica Setting Professional Modifier None Typical Low $42.66 Median $61.66 Typical High $645.65 | Professional | None | $42.66 | $61.66 | $645.65 |
United Setting Facility Modifier None Typical Low $50.12 Median $60.26 Typical High $141.25 | Facility | None | $50.12 | $60.26 | $141.25 |
United Setting Professional Modifier None Typical Low $40.74 Median $60.26 Typical High $93.33 | Professional | None | $40.74 | $60.26 | $93.33 |
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 $32.36 Median $33.88 Typical High $37.15 | Professional | 52 · Reduced service | $32.36 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $13.49 Typical High $14.79 | Professional | 53 · Discontinued | $12.88 | $13.49 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $10.23 Typical High $11.22 | Professional | 55 · Aftercare only | $9.77 | $10.23 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.76 Typical High $7.41 | Professional | 56 · Pre-op care only | $6.46 | $6.76 | $7.41 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.03 Median $6.03 Typical High $60.26 | Professional | RR · Rental | $6.03 | $6.03 | $60.26 |
Where Missouri sits
The same service costs 2.8 times more in Wisconsin 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
$67.61
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.