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 $275.42 Median $275.42 Typical High $316.23 | Facility | None | $275.42 | $275.42 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $288.40 Typical High $316.23 | Professional | None | $275.42 | $288.40 | $316.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $2,454.71 | Facility | None | $537.03 | $537.03 | $2,454.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $323.59 Typical High $426.58 | Professional | None | $295.12 | $323.59 | $426.58 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $204.17 Median $239.88 Typical High $371.54 | Professional | UE · Used equipment | $204.17 | $239.88 | $371.54 |
BCBS Kansas City Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $537.03 | Professional | None | $323.59 | $323.59 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $398.11 | Facility | None | $371.54 | $371.54 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $371.54 | Professional | None | $275.42 | $275.42 | $371.54 |
Medica Setting Facility Modifier None Typical Low $281.84 Median $562.34 Typical High $2,818.38 | Facility | None | $281.84 | $562.34 | $2,818.38 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $263.03 Typical High $3,630.78 | Professional | None | $218.78 | $263.03 | $3,630.78 |
United Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $707.95 | Facility | None | $346.74 | $346.74 | $707.95 |
United Setting Professional Modifier None Typical Low $199.53 Median $263.03 Typical High $398.11 | Professional | None | $199.53 | $263.03 | $398.11 |
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 $138.04 Median $144.54 Typical High $158.49 | Professional | 52 · Reduced service | $138.04 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $57.54 Typical High $63.10 | Professional | 53 · Discontinued | $54.95 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $42.66 Typical High $46.77 | Professional | 55 · Aftercare only | $40.74 | $42.66 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $28.84 Typical High $31.62 | Professional | 56 · Pre-op care only | $27.54 | $28.84 | $31.62 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $32.36 Median $32.36 Typical High $323.59 | Professional | RR · Rental | $32.36 | $32.36 | $323.59 |
Where Missouri sits
The same service costs 4.5 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· 36th of 51
$324
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.