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 $213.80 Median $213.80 Typical High $245.47 | Facility | None | $213.80 | $213.80 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $223.87 Typical High $257.04 | Professional | None | $213.80 | $223.87 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $1,905.46 | Facility | None | $416.87 | $416.87 | $1,905.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $199.53 Median $251.19 Typical High $331.13 | Professional | None | $199.53 | $251.19 | $331.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $154.88 Median $165.96 Typical High $295.12 | Professional | UE · Used equipment | $154.88 | $165.96 | $295.12 |
BCBS Kansas City Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $416.87 | Professional | None | $251.19 | $251.19 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $257.04 | Facility | None | $229.09 | $229.09 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $229.09 | Professional | None | $165.96 | $165.96 | $229.09 |
Medica Setting Facility Modifier None Typical Low $190.55 Median $407.38 Typical High $1,905.46 | Facility | None | $190.55 | $407.38 | $1,905.46 |
Medica Setting Professional Modifier None Typical Low $141.25 Median $204.17 Typical High $2,398.83 | Professional | None | $141.25 | $204.17 | $2,398.83 |
United Setting Facility Modifier None Typical Low $229.09 Median $251.19 Typical High $467.74 | Facility | None | $229.09 | $251.19 | $467.74 |
United Setting Professional Modifier None Typical Low $134.90 Median $194.98 Typical High $302.00 | Professional | None | $134.90 | $194.98 | $302.00 |
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 $107.15 Median $112.20 Typical High $123.03 | Professional | 52 · Reduced service | $107.15 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $44.67 Typical High $48.98 | Professional | 53 · Discontinued | $42.66 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $33.11 Typical High $36.31 | Professional | 55 · Aftercare only | $31.62 | $33.11 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $22.39 Typical High $24.55 | Professional | 56 · Pre-op care only | $21.38 | $22.39 | $24.55 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $20.42 Median $20.42 Typical High $213.80 | Professional | RR · Rental | $20.42 | $20.42 | $213.80 |
Where Missouri sits
The same service costs 3.5 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· 30th of 51
$224
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.