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 $91.20 Median $91.20 Typical High $104.71 | Facility | None | $91.20 | $91.20 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $97.72 Typical High $107.15 | Professional | None | $91.20 | $97.72 | $107.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $831.76 | Facility | None | $177.83 | $177.83 | $831.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $109.65 Typical High $147.91 | Professional | None | $100.00 | $109.65 | $147.91 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $74.13 Median $74.13 Typical High $123.03 | Professional | UE · Used equipment | $74.13 | $74.13 | $123.03 |
BCBS Kansas City Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $177.83 | Professional | None | $107.15 | $107.15 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $131.83 | Facility | None | $120.23 | $120.23 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $120.23 | Professional | None | $87.10 | $87.10 | $120.23 |
Medica Setting Facility Modifier None Typical Low $95.50 Median $177.83 Typical High $870.96 | Facility | None | $95.50 | $177.83 | $870.96 |
Medica Setting Professional Modifier None Typical Low $70.79 Median $87.10 Typical High $1,000.00 | Professional | None | $70.79 | $87.10 | $1,000.00 |
United Setting Facility Modifier None Typical Low $72.44 Median $85.11 Typical High $229.09 | Facility | None | $72.44 | $85.11 | $229.09 |
United Setting Professional Modifier None Typical Low $64.57 Median $87.10 Typical High $131.83 | Professional | None | $64.57 | $87.10 | $131.83 |
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 $45.71 Median $47.86 Typical High $53.70 | Professional | 52 · Reduced service | $45.71 | $47.86 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $19.50 Typical High $21.38 | Professional | 53 · Discontinued | $18.62 | $19.50 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $14.45 Typical High $16.22 | Professional | 55 · Aftercare only | $13.80 | $14.45 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.77 Typical High $10.72 | Professional | 56 · Pre-op care only | $9.12 | $9.77 | $10.72 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.00 Median $10.00 Typical High $100.00 | Professional | RR · Rental | $10.00 | $10.00 | $100.00 |
Where Missouri sits
The same service costs 2.4 times more in Montana than in Vermont. 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
$100
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.