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 $60.26 Median $60.26 Typical High $69.18 | Facility | None | $60.26 | $60.26 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $63.10 Typical High $70.79 | Professional | None | $60.26 | $63.10 | $70.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $537.03 | Facility | None | $117.49 | $117.49 | $537.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $67.61 Typical High $100.00 | Professional | None | $53.70 | $67.61 | $100.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $50.12 Median $51.29 Typical High $85.11 | Professional | UE · Used equipment | $50.12 | $51.29 | $85.11 |
BCBS Kansas City Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $117.49 | Professional | None | $70.79 | $70.79 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $77.62 | Facility | None | $70.79 | $70.79 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None | $51.29 | $51.29 | $70.79 |
Medica Setting Facility Modifier None Typical Low $63.10 Median $112.20 Typical High $537.03 | Facility | None | $63.10 | $112.20 | $537.03 |
Medica Setting Professional Modifier None Typical Low $42.66 Median $57.54 Typical High $588.84 | Professional | None | $42.66 | $57.54 | $588.84 |
United Setting Facility Modifier None Typical Low $57.54 Median $63.10 Typical High $141.25 | Facility | None | $57.54 | $63.10 | $141.25 |
United Setting Professional Modifier None Typical Low $40.74 Median $57.54 Typical High $89.13 | Professional | None | $40.74 | $57.54 | $89.13 |
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 $30.20 Median $31.62 Typical High $34.67 | Professional | 52 · Reduced service | $30.20 | $31.62 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.59 Typical High $14.13 | Professional | 53 · Discontinued | $12.02 | $12.59 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.55 Typical High $10.47 | Professional | 55 · Aftercare only | $9.12 | $9.55 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.31 Typical High $6.92 | Professional | 56 · Pre-op care only | $6.03 | $6.31 | $6.92 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.61 Median $6.61 Typical High $67.61 | Professional | RR · Rental | $6.61 | $6.61 | $67.61 |
Where Missouri sits
The same service costs 2.4 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· 35th of 51
$64.57
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.