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 $21.38 Median $21.38 Typical High $24.55 | Facility | None | $21.38 | $21.38 | $24.55 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $22.39 Typical High $24.55 | Professional | None | $21.38 | $22.39 | $24.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $194.98 | Facility | None | $41.69 | $41.69 | $194.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.18 Median $25.70 Typical High $33.88 | Professional | None | $13.18 | $25.70 | $33.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $10.00 Median $12.59 Typical High $28.84 | Professional | UE · Used equipment | $10.00 | $12.59 | $28.84 |
BCBS Kansas City Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $41.69 | Professional | None | $25.12 | $25.12 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $25.70 | Facility | None | $22.91 | $22.91 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $22.91 | Professional | None | $16.98 | $16.98 | $22.91 |
Medica Setting Facility Modifier None Typical Low $20.42 Median $40.74 Typical High $190.55 | Facility | None | $20.42 | $40.74 | $190.55 |
Medica Setting Professional Modifier None Typical Low $15.49 Median $20.42 Typical High $208.93 | Professional | None | $15.49 | $20.42 | $208.93 |
United Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
United Setting Professional Modifier None Typical Low $14.13 Median $20.42 Typical High $30.90 | Professional | None | $14.13 | $20.42 | $30.90 |
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 $10.72 Median $11.22 Typical High $12.30 | Professional | 52 · Reduced service | $10.72 | $11.22 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $4.57 Typical High $4.90 | Professional | 53 · Discontinued | $4.27 | $4.57 | $4.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.39 Typical High $3.72 | Professional | 55 · Aftercare only | $3.24 | $3.39 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.24 Typical High $2.45 | Professional | 56 · Pre-op care only | $2.14 | $2.24 | $2.45 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.45 Median $13.18 Typical High $13.18 | Professional | RR · Rental | $1.45 | $13.18 | $13.18 |
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· 33rd of 51
$21.88
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.