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 $39.81 Median $39.81 Typical High $45.71 | Facility | None | $39.81 | $39.81 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $41.69 Typical High $45.71 | Professional | None | $39.81 | $41.69 | $45.71 |
Ambetter Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $363.08 | Facility | None | $77.62 | $77.62 | $363.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $44.67 Median $46.77 Typical High $63.10 | Professional | None | $44.67 | $46.77 | $63.10 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $32.36 Median $34.67 Typical High $50.12 | Professional | UE · Used equipment | $32.36 | $34.67 | $50.12 |
BCBS Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $77.62 | Professional | None | $46.77 | $46.77 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $60.26 | Facility | None | $53.70 | $53.70 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $53.70 | Professional | None | $39.81 | $39.81 | $53.70 |
Medica Setting Facility Modifier None Typical Low $39.81 Median $75.86 Typical High $398.11 | Facility | None | $39.81 | $75.86 | $398.11 |
Medica Setting Professional Modifier None Typical Low $31.62 Median $38.02 Typical High $501.19 | Professional | None | $31.62 | $38.02 | $501.19 |
United Setting Facility Modifier None Typical Low $47.86 Median $51.29 Typical High $104.71 | Facility | None | $47.86 | $51.29 | $104.71 |
United Setting Professional Modifier None Typical Low $28.84 Median $38.02 Typical High $58.88 | Professional | None | $28.84 | $38.02 | $58.88 |
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 $19.95 Median $20.89 Typical High $22.91 | Professional | 52 · Reduced service | $19.95 | $20.89 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $8.32 Typical High $9.12 | Professional | 53 · Discontinued | $7.94 | $8.32 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.31 Typical High $6.92 | Professional | 55 · Aftercare only | $6.03 | $6.31 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.17 Typical High $4.57 | Professional | 56 · Pre-op care only | $3.98 | $4.17 | $4.57 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.57 Median $4.57 Typical High $47.86 | Professional | RR · Rental | $4.57 | $4.57 | $47.86 |
Where Missouri sits
The same service costs 3.1 times more in Hawaii than in West Virginia. 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
$45.71
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.