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 $79.43 Median $79.43 Typical High $91.20 | Facility | None | $79.43 | $79.43 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $85.11 Typical High $93.33 | Professional | None | $79.43 | $85.11 | $93.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $724.44 | Facility | None | $154.88 | $154.88 | $724.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $95.50 Typical High $125.89 | Professional | None | $89.13 | $95.50 | $125.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $66.07 Median $69.18 Typical High $107.15 | Professional | UE · Used equipment | $66.07 | $69.18 | $107.15 |
BCBS Kansas City Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $154.88 | Professional | None | $93.33 | $93.33 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $109.65 | Facility | None | $97.72 | $97.72 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $97.72 | Professional | None | $70.79 | $70.79 | $97.72 |
Medica Setting Facility Modifier None Typical Low $79.43 Median $154.88 Typical High $812.83 | Facility | None | $79.43 | $154.88 | $812.83 |
Medica Setting Professional Modifier None Typical Low $63.10 Median $75.86 Typical High $1,000.00 | Professional | None | $63.10 | $75.86 | $1,000.00 |
United Setting Facility Modifier None Typical Low $95.50 Median $100.00 Typical High $204.17 | Facility | None | $95.50 | $100.00 | $204.17 |
United Setting Professional Modifier None Typical Low $57.54 Median $75.86 Typical High $117.49 | Professional | None | $57.54 | $75.86 | $117.49 |
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 $39.81 Median $42.66 Typical High $45.71 | Professional | 52 · Reduced service | $39.81 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.98 Typical High $18.20 | Professional | 53 · Discontinued | $16.22 | $16.98 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.59 Typical High $13.80 | Professional | 55 · Aftercare only | $12.02 | $12.59 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.51 Typical High $9.12 | Professional | 56 · Pre-op care only | $7.94 | $8.51 | $9.12 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.12 Median $9.12 Typical High $93.33 | Professional | RR · Rental | $9.12 | $9.12 | $93.33 |
Where Missouri sits
The same service costs 3.2 times more in Hawaii than in Florida. 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· 38th of 51
$91.20
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.