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 $323.59 Median $323.59 Typical High $371.54 | Facility | None | $323.59 | $323.59 | $371.54 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $338.84 Typical High $371.54 | Professional | None | $323.59 | $338.84 | $371.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $2,884.03 | Facility | None | $630.96 | $630.96 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $512.86 | Professional | None | $323.59 | $380.19 | $512.86 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $257.04 Median $257.04 Typical High $446.68 | Professional | UE · Used equipment | $257.04 | $257.04 | $446.68 |
BCBS Kansas City Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $630.96 | Professional | None | $380.19 | $380.19 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $398.11 | Facility | None | $371.54 | $371.54 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $371.54 | Professional | None | $275.42 | $275.42 | $371.54 |
Medica Setting Facility Modifier None Typical Low $323.59 Median $645.65 Typical High $2,951.21 | Facility | None | $323.59 | $645.65 | $2,951.21 |
Medica Setting Professional Modifier None Typical Low $234.42 Median $309.03 Typical High $3,715.35 | Professional | None | $234.42 | $309.03 | $3,715.35 |
United Setting Facility Modifier None Typical Low $269.15 Median $371.54 Typical High $758.58 | Facility | None | $269.15 | $371.54 | $758.58 |
United Setting Professional Modifier None Typical Low $213.80 Median $309.03 Typical High $467.74 | Professional | None | $213.80 | $309.03 | $467.74 |
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 $162.18 Median $169.82 Typical High $186.21 | Professional | 52 · Reduced service | $162.18 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $67.61 Typical High $74.13 | Professional | 53 · Discontinued | $64.57 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $51.29 Typical High $54.95 | Professional | 55 · Aftercare only | $47.86 | $51.29 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $33.88 Typical High $37.15 | Professional | 56 · Pre-op care only | $32.36 | $33.88 | $37.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $33.88 Median $33.88 Typical High $338.84 | Professional | RR · Rental | $33.88 | $33.88 | $338.84 |
Where Missouri sits
The same service costs 3.0 times more in Hawaii than in Vermont. 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· 33rd of 51
$339
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.