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 $169.82 Median $169.82 Typical High $194.98 | Facility | None | $169.82 | $169.82 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $177.83 Typical High $194.98 | Professional | None | $169.82 | $177.83 | $194.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $1,513.56 | Facility | None | $331.13 | $331.13 | $1,513.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $177.83 Median $199.53 Typical High $263.03 | Professional | None | $177.83 | $199.53 | $263.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $138.04 Median $138.04 Typical High $234.42 | Professional | UE · Used equipment | $138.04 | $138.04 | $234.42 |
BCBS Kansas City Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $331.13 | Professional | None | $194.98 | $194.98 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $208.93 | Facility | None | $186.21 | $186.21 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $186.21 | Professional | None | $138.04 | $138.04 | $186.21 |
Medica Setting Facility Modifier None Typical Low $169.82 Median $309.03 Typical High $1,584.89 | Facility | None | $169.82 | $309.03 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $162.18 Typical High $2,754.23 | Professional | None | $125.89 | $162.18 | $2,754.23 |
United Setting Facility Modifier None Typical Low $199.53 Median $263.03 Typical High $407.38 | Facility | None | $199.53 | $263.03 | $407.38 |
United Setting Professional Modifier None Typical Low $114.82 Median $162.18 Typical High $234.42 | Professional | None | $114.82 | $162.18 | $234.42 |
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 $85.11 Median $89.13 Typical High $95.50 | Professional | 52 · Reduced service | $85.11 | $89.13 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $35.48 Typical High $38.90 | Professional | 53 · Discontinued | $33.88 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $26.30 Typical High $28.84 | Professional | 55 · Aftercare only | $25.12 | $26.30 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $17.78 Typical High $19.50 | Professional | 56 · Pre-op care only | $16.98 | $17.78 | $19.50 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $18.20 Median $18.20 Typical High $181.97 | Professional | RR · Rental | $18.20 | $18.20 | $181.97 |
Where Missouri sits
The same service costs 5.0 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· 28th of 51
$182
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.