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 $30.90 Median $30.90 Typical High $35.48 | Facility | None | $30.90 | $30.90 | $35.48 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $32.36 Typical High $35.48 | Professional | None | $30.90 | $32.36 | $35.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $281.84 | Facility | None | $60.26 | $60.26 | $281.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $37.15 Typical High $48.98 | Professional | None | $30.90 | $37.15 | $48.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $23.44 Median $23.99 Typical High $41.69 | Professional | UE · Used equipment | $23.44 | $23.99 | $41.69 |
BCBS Kansas City Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $60.26 | Professional | None | $36.31 | $36.31 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $35.48 | Facility | None | $33.11 | $33.11 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.11 | Professional | None | $24.55 | $24.55 | $33.11 |
Medica Setting Facility Modifier None Typical Low $29.51 Median $58.88 Typical High $275.42 | Facility | None | $29.51 | $58.88 | $275.42 |
Medica Setting Professional Modifier None Typical Low $22.39 Median $29.51 Typical High $302.00 | Professional | None | $22.39 | $29.51 | $302.00 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
United Setting Professional Modifier None Typical Low $20.42 Median $29.51 Typical High $44.67 | Professional | None | $20.42 | $29.51 | $44.67 |
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 $15.49 Median $16.22 Typical High $17.78 | Professional | 52 · Reduced service | $15.49 | $16.22 | $17.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.61 Typical High $7.08 | Professional | 53 · Discontinued | $6.17 | $6.61 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.90 Typical High $5.37 | Professional | 55 · Aftercare only | $4.68 | $4.90 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.24 Typical High $3.55 | Professional | 56 · Pre-op care only | $3.09 | $3.24 | $3.55 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.16 Median $3.16 Typical High $31.62 | Professional | RR · Rental | $3.16 | $3.16 | $31.62 |
Where Missouri sits
The same service costs 2.8 times more in Kansas 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· 32nd of 51
$32.36
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.