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 $57.54 Median $57.54 Typical High $123.03 | Facility | None | $57.54 | $57.54 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $61.66 Typical High $66.07 | Professional | None | $57.54 | $61.66 | $66.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $524.81 | Facility | None | $112.20 | $112.20 | $524.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $54.95 Typical High $95.50 | Professional | None | $50.12 | $54.95 | $95.50 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $38.02 Median $47.86 Typical High $83.18 | Professional | UE · Used equipment | $38.02 | $47.86 | $83.18 |
BCBS Kansas City Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $112.20 | Professional | None | $67.61 | $67.61 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $60.26 | Facility | None | $53.70 | $53.70 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $53.70 | Professional | None | $38.90 | $38.90 | $53.70 |
Medica Setting Facility Modifier None Typical Low $57.54 Median $100.00 Typical High $457.09 | Facility | None | $57.54 | $100.00 | $457.09 |
Medica Setting Professional Modifier None Typical Low $37.15 Median $54.95 Typical High $549.54 | Professional | None | $37.15 | $54.95 | $549.54 |
United Setting Facility Modifier None Typical Low $16.98 Median $39.81 Typical High $117.49 | Facility | None | $16.98 | $39.81 | $117.49 |
United Setting Professional Modifier None Typical Low $35.48 Median $52.48 Typical High $85.11 | Professional | None | $35.48 | $52.48 | $85.11 |
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 $28.84 Median $30.90 Typical High $33.11 | Professional | 52 · Reduced service | $28.84 | $30.90 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $12.30 Typical High $13.18 | Professional | 53 · Discontinued | $11.75 | $12.30 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $9.12 Typical High $10.00 | Professional | 55 · Aftercare only | $8.71 | $9.12 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.17 Typical High $6.61 | Professional | 56 · Pre-op care only | $5.75 | $6.17 | $6.61 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.01 Median $5.01 Typical High $50.12 | Professional | RR · Rental | $5.01 | $5.01 | $50.12 |
Where Missouri sits
The same service costs 3.3 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· 27th of 51
$54.95
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.