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 $141.25 Median $141.25 Typical High $162.18 | Facility | None | $141.25 | $141.25 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $151.36 Typical High $204.17 | Professional | None | $141.25 | $151.36 | $204.17 |
Ambetter Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $281.84 | Professional | None | $162.18 | $213.80 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $1,288.25 | Facility | None | $275.42 | $275.42 | $1,288.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $158.49 Typical High $239.88 | Professional | None | $128.82 | $158.49 | $239.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $117.49 Median $120.23 Typical High $204.17 | Professional | UE · Used equipment | $117.49 | $120.23 | $204.17 |
BCBS Kansas City Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $275.42 | Professional | None | $165.96 | $165.96 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $158.49 | Facility | None | $141.25 | $141.25 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $141.25 | Professional | None | $104.71 | $104.71 | $141.25 |
Medica Setting Facility Modifier None Typical Low $147.91 Median $275.42 Typical High $1,288.25 | Facility | None | $147.91 | $275.42 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $102.33 Median $134.90 Typical High $1,380.38 | Professional | None | $102.33 | $134.90 | $1,380.38 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $95.50 Median $134.90 Typical High $208.93 | Professional | None | $95.50 | $134.90 | $208.93 |
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 $70.79 Median $75.86 Typical High $81.28 | Professional | 52 · Reduced service | $70.79 | $75.86 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $30.20 Typical High $32.36 | Professional | 53 · Discontinued | $28.84 | $30.20 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $22.39 Typical High $24.55 | Professional | 55 · Aftercare only | $21.38 | $22.39 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $15.14 Typical High $16.22 | Professional | 56 · Pre-op care only | $14.13 | $15.14 | $16.22 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $15.85 Median $15.85 Typical High $158.49 | Professional | RR · Rental | $15.85 | $15.85 | $158.49 |
Where Missouri sits
The same service costs 2.2 times more in Hawaii 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· 42nd of 51
$145
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.