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 $72.44 Median $72.44 Typical High $83.18 | Facility | None | $72.44 | $72.44 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $75.86 Typical High $83.18 | Professional | None | $72.44 | $75.86 | $83.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $645.65 | Facility | None | $141.25 | $141.25 | $645.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $85.11 Typical High $114.82 | Professional | None | $79.43 | $85.11 | $114.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $53.70 Median $63.10 Typical High $97.72 | Professional | UE · Used equipment | $53.70 | $63.10 | $97.72 |
BCBS Kansas City Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $141.25 | Professional | None | $85.11 | $85.11 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $100.00 | Facility | None | $89.13 | $89.13 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $89.13 | Professional | None | $66.07 | $66.07 | $89.13 |
Medica Setting Facility Modifier None Typical Low $72.44 Median $138.04 Typical High $741.31 | Facility | None | $72.44 | $138.04 | $741.31 |
Medica Setting Professional Modifier None Typical Low $57.54 Median $69.18 Typical High $1,380.38 | Professional | None | $57.54 | $69.18 | $1,380.38 |
United Setting Facility Modifier None Typical Low $93.33 Median $114.82 Typical High $190.55 | Facility | None | $93.33 | $114.82 | $190.55 |
United Setting Professional Modifier None Typical Low $52.48 Median $69.18 Typical High $107.15 | Professional | None | $52.48 | $69.18 | $107.15 |
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 $36.31 Median $38.02 Typical High $41.69 | Professional | 52 · Reduced service | $36.31 | $38.02 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $15.14 Typical High $16.60 | Professional | 53 · Discontinued | $14.45 | $15.14 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $11.48 Typical High $12.59 | Professional | 55 · Aftercare only | $10.96 | $11.48 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.59 Typical High $8.32 | Professional | 56 · Pre-op care only | $7.24 | $7.59 | $8.32 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.51 Median $8.51 Typical High $85.11 | Professional | RR · Rental | $8.51 | $8.51 | $85.11 |
Where Missouri sits
The same service costs 5.1 times more in Hawaii 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· 33rd of 51
$85.11
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.