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 $100.00 Median $100.00 Typical High $114.82 | Facility | None | $100.00 | $100.00 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $104.71 Typical High $114.82 | Professional | None | $100.00 | $104.71 | $114.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $912.01 | Facility | None | $194.98 | $194.98 | $912.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $112.20 Typical High $162.18 | Professional | None | $100.00 | $112.20 | $162.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $75.86 Median $81.28 Typical High $123.03 | Professional | UE · Used equipment | $75.86 | $81.28 | $123.03 |
BCBS Kansas City Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $194.98 | Professional | None | $117.49 | $117.49 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $120.23 | Facility | None | $107.15 | $107.15 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $107.15 | Professional | None | $79.43 | $79.43 | $107.15 |
Medica Setting Facility Modifier None Typical Low $95.50 Median $190.55 Typical High $891.25 | Facility | None | $95.50 | $190.55 | $891.25 |
Medica Setting Professional Modifier None Typical Low $72.44 Median $95.50 Typical High $977.24 | Professional | None | $72.44 | $95.50 | $977.24 |
United Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
United Setting Professional Modifier None Typical Low $66.07 Median $95.50 Typical High $144.54 | Professional | None | $66.07 | $95.50 | $144.54 |
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 $50.12 Median $52.48 Typical High $57.54 | Professional | 52 · Reduced service | $50.12 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $21.38 Typical High $22.91 | Professional | 53 · Discontinued | $19.95 | $21.38 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.85 Typical High $17.38 | Professional | 55 · Aftercare only | $15.14 | $15.85 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.47 Typical High $11.48 | Professional | 56 · Pre-op care only | $10.00 | $10.47 | $11.48 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.00 Median $10.00 Typical High $100.00 | Professional | RR · Rental | $10.00 | $10.00 | $100.00 |
Where Missouri sits
The same service costs 2.6 times more in Montana 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· 28th of 51
$105
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.