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 $251.19 Median $251.19 Typical High $288.40 | Facility | None | $251.19 | $251.19 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $263.03 Typical High $288.40 | Professional | None | $251.19 | $263.03 | $288.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $2,238.72 | Facility | None | $489.78 | $489.78 | $2,238.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $295.12 Typical High $389.05 | Professional | None | $275.42 | $295.12 | $389.05 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $204.17 Median $218.78 Typical High $338.84 | Professional | UE · Used equipment | $204.17 | $218.78 | $338.84 |
BCBS Kansas City Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $489.78 | Professional | None | $288.40 | $288.40 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $331.13 | Facility | None | $295.12 | $295.12 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $295.12 | Professional | None | $218.78 | $218.78 | $295.12 |
Medica Setting Facility Modifier None Typical Low $251.19 Median $501.19 Typical High $2,570.40 | Facility | None | $251.19 | $501.19 | $2,570.40 |
Medica Setting Professional Modifier None Typical Low $199.53 Median $239.88 Typical High $3,630.78 | Professional | None | $199.53 | $239.88 | $3,630.78 |
United Setting Facility Modifier None Typical Low $316.23 Median $346.74 Typical High $645.65 | Facility | None | $316.23 | $346.74 | $645.65 |
United Setting Professional Modifier None Typical Low $181.97 Median $239.88 Typical High $363.08 | Professional | None | $181.97 | $239.88 | $363.08 |
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 $125.89 Median $131.83 Typical High $141.25 | Professional | 52 · Reduced service | $125.89 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $52.48 Typical High $57.54 | Professional | 53 · Discontinued | $50.12 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $38.90 Typical High $42.66 | Professional | 55 · Aftercare only | $37.15 | $38.90 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $26.30 Typical High $28.84 | Professional | 56 · Pre-op care only | $25.12 | $26.30 | $28.84 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $28.84 Median $28.84 Typical High $295.12 | Professional | RR · Rental | $28.84 | $28.84 | $295.12 |
Where Missouri sits
The same service costs 4.2 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· 36th of 51
$288
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.