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 $31.62 Median $31.62 Typical High $36.31 | Facility | None | $31.62 | $31.62 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $33.11 Typical High $39.81 | Professional | None | $31.62 | $33.11 | $39.81 |
Ambetter Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $56.23 | Professional | None | $41.69 | $41.69 | $56.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $281.84 | Facility | None | $61.66 | $61.66 | $281.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $35.48 Median $37.15 Typical High $50.12 | Professional | None | $35.48 | $37.15 | $50.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $26.30 Median $27.54 Typical High $42.66 | Professional | UE · Used equipment | $26.30 | $27.54 | $42.66 |
BCBS Kansas City Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $61.66 | Professional | None | $37.15 | $37.15 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $53.70 | Facility | None | $48.98 | $48.98 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $48.98 | Professional | None | $35.48 | $35.48 | $48.98 |
Medica Setting Facility Modifier None Typical Low $31.62 Median $60.26 Typical High $331.13 | Facility | None | $31.62 | $60.26 | $331.13 |
Medica Setting Professional Modifier None Typical Low $25.12 Median $30.20 Typical High $524.81 | Professional | None | $25.12 | $30.20 | $524.81 |
United Setting Facility Modifier None Typical Low $40.74 Median $52.48 Typical High $83.18 | Facility | None | $40.74 | $52.48 | $83.18 |
United Setting Professional Modifier None Typical Low $22.91 Median $30.20 Typical High $46.77 | Professional | None | $22.91 | $30.20 | $46.77 |
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 $15.85 Median $16.60 Typical High $18.62 | Professional | 52 · Reduced service | $15.85 | $16.60 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.61 Typical High $7.41 | Professional | 53 · Discontinued | $6.31 | $6.61 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $5.01 Typical High $5.50 | Professional | 55 · Aftercare only | $4.79 | $5.01 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.31 Typical High $3.72 | Professional | 56 · Pre-op care only | $3.16 | $3.31 | $3.72 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.63 Median $3.63 Typical High $37.15 | Professional | RR · Rental | $3.63 | $3.63 | $37.15 |
Where Missouri sits
The same service costs 4.0 times more in Hawaii than in Washington, DC. 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· 29th of 51
$37.15
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.