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 $144.54 Median $144.54 Typical High $165.96 | Facility | None | $144.54 | $144.54 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $151.36 Typical High $165.96 | Professional | None | $144.54 | $151.36 | $165.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $1,288.25 | Facility | None | $281.84 | $281.84 | $1,288.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $169.82 Typical High $223.87 | Professional | None | $158.49 | $169.82 | $223.87 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $114.82 Median $123.03 Typical High $194.98 | Professional | UE · Used equipment | $114.82 | $123.03 | $194.98 |
BCBS Kansas City Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $281.84 | Professional | None | $165.96 | $165.96 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $181.97 | Facility | None | $169.82 | $169.82 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $169.82 | Professional | None | $125.89 | $125.89 | $169.82 |
Medica Setting Facility Modifier None Typical Low $144.54 Median $288.40 Typical High $1,445.44 | Facility | None | $144.54 | $288.40 | $1,445.44 |
Medica Setting Professional Modifier None Typical Low $114.82 Median $138.04 Typical High $2,344.23 | Professional | None | $114.82 | $138.04 | $2,344.23 |
United Setting Facility Modifier None Typical Low $181.97 Median $229.09 Typical High $371.54 | Facility | None | $181.97 | $229.09 | $371.54 |
United Setting Professional Modifier None Typical Low $104.71 Median $138.04 Typical High $208.93 | Professional | None | $104.71 | $138.04 | $208.93 |
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 $72.44 Median $75.86 Typical High $81.28 | Professional | 52 · Reduced service | $72.44 | $75.86 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $30.20 Typical High $33.11 | Professional | 53 · Discontinued | $28.84 | $30.20 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $22.39 Typical High $24.55 | Professional | 55 · Aftercare only | $21.38 | $22.39 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $15.14 Typical High $16.60 | Professional | 56 · Pre-op care only | $14.45 | $15.14 | $16.60 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $16.22 Median $16.22 Typical High $162.18 | Professional | RR · Rental | $16.22 | $16.22 | $162.18 |
Where Missouri sits
The same service costs 4.7 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· 31st of 51
$162
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.