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 $51.29 Median $51.29 Typical High $58.88 | Facility | None | $51.29 | $51.29 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $53.70 Typical High $72.44 | Professional | None | $51.29 | $53.70 | $72.44 |
Ambetter Setting Professional Modifier None Typical Low $69.18 Median $89.13 Typical High $134.90 | Professional | None | $69.18 | $89.13 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $457.09 | Facility | None | $100.00 | $100.00 | $457.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $45.71 Median $57.54 Typical High $85.11 | Professional | None | $45.71 | $57.54 | $85.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $43.65 Typical High $75.86 | Professional | UE · Used equipment | $42.66 | $43.65 | $75.86 |
BCBS Kansas City Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $100.00 | Professional | None | $60.26 | $60.26 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $61.66 Typical High $67.61 | Facility | None | $60.26 | $61.66 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $60.26 | Professional | None | $44.67 | $44.67 | $60.26 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $100.00 Typical High $478.63 | Facility | None | $54.95 | $100.00 | $478.63 |
Medica Setting Professional Modifier None Typical Low $39.81 Median $48.98 Typical High $524.81 | Professional | None | $39.81 | $48.98 | $524.81 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $131.83 | Facility | None | $72.44 | $72.44 | $131.83 |
United Setting Professional Modifier None Typical Low $37.15 Median $48.98 Typical High $75.86 | Professional | None | $37.15 | $48.98 | $75.86 |
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 $25.70 Median $26.92 Typical High $29.51 | Professional | 52 · Reduced service | $25.70 | $26.92 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.72 Typical High $11.75 | Professional | 53 · Discontinued | $10.23 | $10.72 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $8.13 Typical High $8.71 | Professional | 55 · Aftercare only | $7.76 | $8.13 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.37 Typical High $5.89 | Professional | 56 · Pre-op care only | $5.13 | $5.37 | $5.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.62 Median $5.62 Typical High $57.54 | Professional | RR · Rental | $5.62 | $5.62 | $57.54 |
Where Missouri sits
The same service costs 2.1 times more in Wisconsin than in New Jersey. 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· 37th of 51
$57.54
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.