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 $67.61 Median $67.61 Typical High $77.62 | Facility | None | $67.61 | $67.61 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $70.79 Typical High $77.62 | Professional | None | $67.61 | $70.79 | $77.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $602.56 | Facility | None | $131.83 | $131.83 | $602.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $75.86 Typical High $104.71 | Professional | None | $61.66 | $75.86 | $104.71 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $45.71 Median $45.71 Typical High $91.20 | Professional | UE · Used equipment | $45.71 | $45.71 | $91.20 |
BCBS Kansas City Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $131.83 | Professional | None | $79.43 | $79.43 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $74.13 | Facility | None | $66.07 | $66.07 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $66.07 | Professional | None | $48.98 | $48.98 | $66.07 |
Medica Setting Facility Modifier None Typical Low $61.66 Median $128.82 Typical High $562.34 | Facility | None | $61.66 | $128.82 | $562.34 |
Medica Setting Professional Modifier None Typical Low $43.65 Median $64.57 Typical High $691.83 | Professional | None | $43.65 | $64.57 | $691.83 |
United Setting Facility Modifier None Typical Low $61.66 Median $69.18 Typical High $141.25 | Facility | None | $61.66 | $69.18 | $141.25 |
United Setting Professional Modifier None Typical Low $42.66 Median $61.66 Typical High $97.72 | Professional | None | $42.66 | $61.66 | $97.72 |
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 $33.88 Median $35.48 Typical High $38.90 | Professional | 52 · Reduced service | $33.88 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $14.13 Typical High $15.49 | Professional | 53 · Discontinued | $13.49 | $14.13 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.72 Typical High $11.75 | Professional | 55 · Aftercare only | $10.23 | $10.72 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.08 Typical High $7.76 | Professional | 56 · Pre-op care only | $6.76 | $7.08 | $7.76 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.17 Median $6.17 Typical High $61.66 | Professional | RR · Rental | $6.17 | $6.17 | $61.66 |
Where Missouri sits
The same service costs 3.5 times more in Hawaii than in Florida. 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
$66.07
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.