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 $54.95 Median $54.95 Typical High $61.66 | Facility | None | $54.95 | $54.95 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $57.54 Typical High $61.66 | Professional | None | $54.95 | $57.54 | $61.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $489.78 | Facility | None | $107.15 | $107.15 | $489.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $64.57 Typical High $85.11 | Professional | None | $54.95 | $64.57 | $85.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $41.69 Median $42.66 Typical High $74.13 | Professional | UE · Used equipment | $41.69 | $42.66 | $74.13 |
BCBS Kansas City Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $107.15 | Professional | None | $63.10 | $63.10 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $64.57 | Facility | None | $58.88 | $58.88 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $58.88 | Professional | None | $42.66 | $42.66 | $58.88 |
Medica Setting Facility Modifier None Typical Low $52.48 Median $104.71 Typical High $478.63 | Facility | None | $52.48 | $104.71 | $478.63 |
Medica Setting Professional Modifier None Typical Low $38.90 Median $52.48 Typical High $616.60 | Professional | None | $38.90 | $52.48 | $616.60 |
United Setting Facility Modifier None Typical Low $40.74 Median $46.77 Typical High $128.82 | Facility | None | $40.74 | $46.77 | $128.82 |
United Setting Professional Modifier None Typical Low $36.31 Median $52.48 Typical High $79.43 | Professional | None | $36.31 | $52.48 | $79.43 |
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 $26.92 Median $28.84 Typical High $30.90 | Professional | 52 · Reduced service | $26.92 | $28.84 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $11.48 Typical High $12.59 | Professional | 53 · Discontinued | $10.96 | $11.48 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.51 Typical High $9.33 | Professional | 55 · Aftercare only | $8.13 | $8.51 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.75 Typical High $6.31 | Professional | 56 · Pre-op care only | $5.50 | $5.75 | $6.31 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.75 Median $5.75 Typical High $58.88 | Professional | RR · Rental | $5.75 | $5.75 | $58.88 |
Where Missouri sits
The same service costs 2.5 times more in Arkansas 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
$58.88
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.