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 $18.20 Median $18.20 Typical High $20.89 | Facility | None | $18.20 | $18.20 | $20.89 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $19.50 Typical High $20.89 | Professional | None | $18.20 | $19.50 | $20.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $165.96 | Facility | None | $35.48 | $35.48 | $165.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.62 Median $22.39 Typical High $29.51 | Professional | None | $18.62 | $22.39 | $29.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $13.80 Median $15.14 Typical High $22.39 | Professional | UE · Used equipment | $13.80 | $15.14 | $22.39 |
BCBS Kansas City Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $35.48 | Professional | None | $21.38 | $21.38 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $26.92 | Facility | None | $24.55 | $24.55 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $24.55 | Professional | None | $17.78 | $17.78 | $24.55 |
Medica Setting Facility Modifier None Typical Low $17.38 Median $34.67 Typical High $165.96 | Facility | None | $17.38 | $34.67 | $165.96 |
Medica Setting Professional Modifier None Typical Low $13.18 Median $17.38 Typical High $177.83 | Professional | None | $13.18 | $17.38 | $177.83 |
United Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
United Setting Professional Modifier None Typical Low $12.02 Median $17.38 Typical High $26.92 | Professional | None | $12.02 | $17.38 | $26.92 |
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 $9.12 Median $9.55 Typical High $10.47 | Professional | 52 · Reduced service | $9.12 | $9.55 | $10.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.89 Typical High $4.17 | Professional | 53 · Discontinued | $3.63 | $3.89 | $4.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $2.88 Typical High $3.16 | Professional | 55 · Aftercare only | $2.75 | $2.88 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.95 Typical High $2.09 | Professional | 56 · Pre-op care only | $1.82 | $1.95 | $2.09 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.82 Median $1.82 Typical High $18.62 | Professional | RR · Rental | $1.82 | $1.82 | $18.62 |
Where Missouri sits
The same service costs 2.1 times more in Montana than in West Virginia. 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· 36th of 51
$18.62
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.