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 $223.87 Median $223.87 Typical High $257.04 | Facility | None | $223.87 | $223.87 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $234.42 Typical High $295.12 | Professional | None | $223.87 | $234.42 | $295.12 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $380.19 | Professional | None | $138.04 | $138.04 | $380.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $2,041.74 | Facility | None | $436.52 | $436.52 | $2,041.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $263.03 Typical High $354.81 | Professional | None | $239.88 | $263.03 | $354.81 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $186.21 Median $186.21 Typical High $309.03 | Professional | UE · Used equipment | $186.21 | $186.21 | $309.03 |
BCBS Kansas City Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $436.52 | Professional | None | $263.03 | $263.03 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $295.12 | Facility | None | $263.03 | $263.03 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $263.03 | Professional | None | $194.98 | $194.98 | $263.03 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $426.58 Typical High $2,238.72 | Facility | None | $223.87 | $426.58 | $2,238.72 |
Medica Setting Professional Modifier None Typical Low $169.82 Median $213.80 Typical High $3,715.35 | Professional | None | $169.82 | $213.80 | $3,715.35 |
United Setting Facility Modifier None Typical Low $213.80 Median $275.42 Typical High $562.34 | Facility | None | $213.80 | $275.42 | $562.34 |
United Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $323.59 | Professional | None | $158.49 | $213.80 | $323.59 |
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 $112.20 Median $117.49 Typical High $128.82 | Professional | 52 · Reduced service | $112.20 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $46.77 Typical High $51.29 | Professional | 53 · Discontinued | $44.67 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $35.48 Typical High $38.90 | Professional | 55 · Aftercare only | $33.88 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $23.44 Typical High $25.70 | Professional | 56 · Pre-op care only | $22.39 | $23.44 | $25.70 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $24.55 Median $24.55 Typical High $251.19 | Professional | RR · Rental | $24.55 | $24.55 | $251.19 |
Where Missouri sits
The same service costs 4.7 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· 34th of 51
$251
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.