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 $467.74 Median $467.74 Typical High $537.03 | Facility | None | $467.74 | $467.74 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $489.78 Typical High $537.03 | Professional | None | $467.74 | $489.78 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $4,168.69 | Facility | None | $912.01 | $912.01 | $4,168.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $512.86 Typical High $724.44 | Professional | None | $478.63 | $512.86 | $724.44 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $363.08 Median $363.08 Typical High $630.96 | Professional | UE · Used equipment | $363.08 | $363.08 | $630.96 |
BCBS Kansas City Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $912.01 | Professional | None | $537.03 | $537.03 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $562.34 | Facility | None | $512.86 | $512.86 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $512.86 | Professional | None | $371.54 | $371.54 | $512.86 |
Medica Setting Facility Modifier None Typical Low $467.74 Median $891.25 Typical High $4,365.16 | Facility | None | $467.74 | $891.25 | $4,365.16 |
Medica Setting Professional Modifier None Typical Low $338.84 Median $446.68 Typical High $5,248.07 | Professional | None | $338.84 | $446.68 | $5,248.07 |
United Setting Facility Modifier None Typical Low $478.63 Median $549.54 Typical High $1,122.02 | Facility | None | $478.63 | $549.54 | $1,122.02 |
United Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $676.08 | Professional | None | $316.23 | $446.68 | $676.08 |
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 $234.42 Median $245.47 Typical High $263.03 | Professional | 52 · Reduced service | $234.42 | $245.47 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $97.72 Typical High $107.15 | Professional | 53 · Discontinued | $93.33 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $72.44 Typical High $79.43 | Professional | 55 · Aftercare only | $69.18 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $48.98 Typical High $53.70 | Professional | 56 · Pre-op care only | $46.77 | $48.98 | $53.70 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $48.98 Median $48.98 Typical High $489.78 | Professional | RR · Rental | $48.98 | $48.98 | $489.78 |
Where Missouri sits
The same service costs 3.2 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· 32nd of 51
$501
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.