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 $190.55 Median $190.55 Typical High $218.78 | Facility | None | $190.55 | $190.55 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $199.53 Typical High $218.78 | Professional | None | $190.55 | $199.53 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $1,698.24 | Facility | None | $371.54 | $371.54 | $1,698.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $218.78 Typical High $295.12 | Professional | None | $204.17 | $218.78 | $295.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $151.36 Median $158.49 Typical High $257.04 | Professional | UE · Used equipment | $151.36 | $158.49 | $257.04 |
BCBS Kansas City Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $371.54 | Professional | None | $223.87 | $223.87 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $239.88 | Facility | None | $213.80 | $213.80 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $213.80 | Professional | None | $158.49 | $158.49 | $213.80 |
Medica Setting Facility Modifier None Typical Low $190.55 Median $363.08 Typical High $1,862.09 | Facility | None | $190.55 | $363.08 | $1,862.09 |
Medica Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $2,818.38 | Professional | None | $144.54 | $181.97 | $2,818.38 |
United Setting Facility Modifier None Typical Low $229.09 Median $257.04 Typical High $467.74 | Facility | None | $229.09 | $257.04 | $467.74 |
United Setting Professional Modifier None Typical Low $131.83 Median $181.97 Typical High $275.42 | Professional | None | $131.83 | $181.97 | $275.42 |
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 $95.50 Median $100.00 Typical High $109.65 | Professional | 52 · Reduced service | $95.50 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $39.81 Typical High $43.65 | Professional | 53 · Discontinued | $38.02 | $39.81 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $30.20 Typical High $32.36 | Professional | 55 · Aftercare only | $28.84 | $30.20 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.95 Typical High $21.88 | Professional | 56 · Pre-op care only | $19.05 | $19.95 | $21.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $20.89 Median $20.89 Typical High $208.93 | Professional | RR · Rental | $20.89 | $20.89 | $208.93 |
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· 38th of 51
$209
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.