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 $42.66 Median $42.66 Typical High $48.98 | Facility | None | $42.66 | $42.66 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $44.67 Typical High $48.98 | Professional | None | $42.66 | $44.67 | $48.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $380.19 | Facility | None | $83.18 | $83.18 | $380.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.90 Median $46.77 Typical High $66.07 | Professional | None | $38.90 | $46.77 | $66.07 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $28.84 Median $30.90 Typical High $56.23 | Professional | UE · Used equipment | $28.84 | $30.90 | $56.23 |
BCBS Kansas City Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $83.18 | Professional | None | $50.12 | $50.12 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $83.18 | Facility | None | $56.23 | $56.23 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $56.23 | Professional | None | $40.74 | $40.74 | $56.23 |
Medica Setting Facility Modifier None Typical Low $37.15 Median $77.62 Typical High $363.08 | Facility | None | $37.15 | $77.62 | $363.08 |
Medica Setting Professional Modifier None Typical Low $27.54 Median $40.74 Typical High $489.78 | Professional | None | $27.54 | $40.74 | $489.78 |
United Setting Facility Modifier None Typical Low $43.65 Median $89.13 Typical High $89.13 | Facility | None | $43.65 | $89.13 | $89.13 |
United Setting Professional Modifier None Typical Low $26.92 Median $38.90 Typical High $58.88 | Professional | None | $26.92 | $38.90 | $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 $21.38 Median $22.39 Typical High $24.55 | Professional | 52 · Reduced service | $21.38 | $22.39 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.91 Typical High $9.77 | Professional | 53 · Discontinued | $8.51 | $8.91 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.61 Typical High $7.24 | Professional | 55 · Aftercare only | $6.31 | $6.61 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.47 Typical High $4.90 | Professional | 56 · Pre-op care only | $4.27 | $4.47 | $4.90 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.98 Median $5.37 Typical High $39.81 | Professional | RR · Rental | $3.98 | $5.37 | $39.81 |
Where Missouri sits
The same service costs 3.1 times more in Hawaii than in Kentucky. 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
$42.66
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.