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 $125.89 Median $125.89 Typical High $141.25 | Facility | None | $125.89 | $125.89 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $131.83 Typical High $144.54 | Professional | None | $125.89 | $131.83 | $144.54 |
Ambetter Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $1,122.02 | Facility | None | $239.88 | $239.88 | $1,122.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $151.36 Typical High $194.98 | Professional | None | $100.00 | $151.36 | $194.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $70.79 Median $102.33 Typical High $165.96 | Professional | UE · Used equipment | $70.79 | $102.33 | $165.96 |
BCBS Kansas City Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $239.88 | Professional | None | $144.54 | $144.54 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $169.82 | Facility | None | $151.36 | $151.36 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $151.36 | Professional | None | $112.20 | $112.20 | $151.36 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $239.88 Typical High $1,122.02 | Facility | None | $125.89 | $239.88 | $1,122.02 |
Medica Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $1,202.26 | Professional | None | $89.13 | $117.49 | $1,202.26 |
United Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
United Setting Professional Modifier None Typical Low $81.28 Median $117.49 Typical High $181.97 | Professional | None | $81.28 | $117.49 | $181.97 |
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 $61.66 Median $66.07 Typical High $70.79 | Professional | 52 · Reduced service | $61.66 | $66.07 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $26.30 Typical High $28.84 | Professional | 53 · Discontinued | $25.12 | $26.30 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $19.50 Typical High $21.38 | Professional | 55 · Aftercare only | $18.62 | $19.50 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $13.18 Typical High $14.13 | Professional | 56 · Pre-op care only | $12.59 | $13.18 | $14.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.48 Median $11.48 Typical High $117.49 | Professional | RR · Rental | $11.48 | $11.48 | $117.49 |
Where Missouri sits
The same service costs 2.1 times more in Hawaii than in Utah. 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· 30th of 51
$135
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.