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 $46.77 Median $46.77 Typical High $52.48 | Facility | None | $46.77 | $46.77 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $48.98 Typical High $53.70 | Professional | None | $46.77 | $48.98 | $53.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $416.87 | Facility | None | $91.20 | $91.20 | $416.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $56.23 Typical High $72.44 | Professional | None | $46.77 | $56.23 | $72.44 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $34.67 Median $34.67 Typical High $61.66 | Professional | UE · Used equipment | $34.67 | $34.67 | $61.66 |
BCBS Kansas City Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $91.20 | Professional | None | $53.70 | $53.70 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $54.95 | Facility | None | $50.12 | $50.12 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $50.12 | Professional | None | $36.31 | $36.31 | $50.12 |
Medica Setting Facility Modifier None Typical Low $44.67 Median $89.13 Typical High $416.87 | Facility | None | $44.67 | $89.13 | $416.87 |
Medica Setting Professional Modifier None Typical Low $33.11 Median $43.65 Typical High $446.68 | Professional | None | $33.11 | $43.65 | $446.68 |
United Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
United Setting Professional Modifier None Typical Low $30.20 Median $43.65 Typical High $67.61 | Professional | None | $30.20 | $43.65 | $67.61 |
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 $22.91 Median $24.55 Typical High $26.30 | Professional | 52 · Reduced service | $22.91 | $24.55 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.77 Typical High $10.72 | Professional | 53 · Discontinued | $9.33 | $9.77 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $7.24 Typical High $7.94 | Professional | 55 · Aftercare only | $6.92 | $7.24 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.90 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.68 | $4.90 | $5.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.68 Median $4.68 Typical High $47.86 | Professional | RR · Rental | $4.68 | $4.68 | $47.86 |
Where Missouri sits
The same service costs 3.0 times more in Hawaii than in Kansas. 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
$47.86
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.