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 $177.83 Median $177.83 Typical High $204.17 | Facility | None | $177.83 | $177.83 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $186.21 Typical High $204.17 | Professional | None | $177.83 | $186.21 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $1,621.81 | Facility | None | $346.74 | $346.74 | $1,621.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $281.84 | Professional | None | $151.36 | $208.93 | $281.84 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $112.20 Median $125.89 Typical High $239.88 | Professional | UE · Used equipment | $112.20 | $125.89 | $239.88 |
BCBS Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $346.74 | Professional | None | $208.93 | $208.93 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $169.82 | Facility | None | $158.49 | $158.49 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $158.49 | Professional | None | $117.49 | $117.49 | $158.49 |
Medica Setting Facility Modifier None Typical Low $141.25 Median $331.13 Typical High $1,412.54 | Facility | None | $141.25 | $331.13 | $1,412.54 |
Medica Setting Professional Modifier None Typical Low $112.20 Median $169.82 Typical High $1,862.09 | Professional | None | $112.20 | $169.82 | $1,862.09 |
United Setting Facility Modifier None Typical Low $141.25 Median $169.82 Typical High $346.74 | Facility | None | $141.25 | $169.82 | $346.74 |
United Setting Professional Modifier None Typical Low $107.15 Median $158.49 Typical High $251.19 | Professional | None | $107.15 | $158.49 | $251.19 |
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 $89.13 Median $93.33 Typical High $102.33 | Professional | 52 · Reduced service | $89.13 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $37.15 Typical High $40.74 | Professional | 53 · Discontinued | $35.48 | $37.15 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $28.18 Typical High $30.90 | Professional | 55 · Aftercare only | $26.92 | $28.18 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $18.62 Typical High $20.42 | Professional | 56 · Pre-op care only | $17.78 | $18.62 | $20.42 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $15.49 Median $15.49 Typical High $154.88 | Professional | RR · Rental | $15.49 | $15.49 | $154.88 |
Where Missouri sits
The same service costs 4.4 times more in Hawaii than in Kansas. 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· 20th of 51
$178
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.