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 $120.23 Median $120.23 Typical High $138.04 | Facility | None | $120.23 | $120.23 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $138.04 | Professional | None | $120.23 | $125.89 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $1,096.48 | Facility | None | $234.42 | $234.42 | $1,096.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $131.83 Median $144.54 Typical High $190.55 | Professional | None | $131.83 | $144.54 | $190.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $97.72 Median $102.33 Typical High $162.18 | Professional | UE · Used equipment | $97.72 | $102.33 | $162.18 |
BCBS Kansas City Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $234.42 | Professional | None | $141.25 | $141.25 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $186.21 | Facility | None | $165.96 | $165.96 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | None | $120.23 | $120.23 | $165.96 |
Medica Setting Facility Modifier None Typical Low $120.23 Median $251.19 Typical High $1,230.27 | Facility | None | $120.23 | $251.19 | $1,230.27 |
Medica Setting Professional Modifier None Typical Low $95.50 Median $114.82 Typical High $2,137.96 | Professional | None | $95.50 | $114.82 | $2,137.96 |
United Setting Facility Modifier None Typical Low $154.88 Median $213.80 Typical High $316.23 | Facility | None | $154.88 | $213.80 | $316.23 |
United Setting Professional Modifier None Typical Low $87.10 Median $114.82 Typical High $177.83 | Professional | None | $87.10 | $114.82 | $177.83 |
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 $60.26 Median $63.10 Typical High $69.18 | Professional | 52 · Reduced service | $60.26 | $63.10 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $25.70 Typical High $27.54 | Professional | 53 · Discontinued | $23.99 | $25.70 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $19.05 Typical High $20.89 | Professional | 55 · Aftercare only | $18.20 | $19.05 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.59 Typical High $13.80 | Professional | 56 · Pre-op care only | $12.02 | $12.59 | $13.80 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.80 Median $13.80 Typical High $138.04 | Professional | RR · Rental | $13.80 | $13.80 | $138.04 |
Where Missouri sits
The same service costs 4.4 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· 42nd of 51
$138
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.