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 $26.30 Median $26.30 Typical High $30.20 | Facility | None | $26.30 | $26.30 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $27.54 Typical High $30.20 | Professional | None | $26.30 | $27.54 | $30.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $234.42 | Facility | None | $51.29 | $51.29 | $234.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.30 Median $31.62 Typical High $41.69 | Professional | None | $26.30 | $31.62 | $41.69 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $19.95 Median $20.42 Typical High $35.48 | Professional | UE · Used equipment | $19.95 | $20.42 | $35.48 |
BCBS Kansas City Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $51.29 | Professional | None | $30.90 | $30.90 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $36.31 | Facility | None | $33.88 | $33.88 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.88 | Professional | None | $24.55 | $24.55 | $33.88 |
Medica Setting Facility Modifier None Typical Low $25.12 Median $50.12 Typical High $234.42 | Facility | None | $25.12 | $50.12 | $234.42 |
Medica Setting Professional Modifier None Typical Low $18.62 Median $25.12 Typical High $257.04 | Professional | None | $18.62 | $25.12 | $257.04 |
United Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
United Setting Professional Modifier None Typical Low $17.38 Median $25.12 Typical High $38.02 | Professional | None | $17.38 | $25.12 | $38.02 |
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 $13.18 Median $13.80 Typical High $15.14 | Professional | 52 · Reduced service | $13.18 | $13.80 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.50 Typical High $6.03 | Professional | 53 · Discontinued | $5.25 | $5.50 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $4.17 Typical High $4.47 | Professional | 55 · Aftercare only | $3.98 | $4.17 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.75 Typical High $3.02 | Professional | 56 · Pre-op care only | $2.63 | $2.75 | $3.02 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.75 Median $2.75 Typical High $27.54 | Professional | RR · Rental | $2.75 | $2.75 | $27.54 |
Where Missouri sits
The same service costs 2.2 times more in Montana than in Arizona. 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
$27.54
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.