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 $52.48 Median $60.26 Typical High $81.28 | Facility | None | $52.48 | $60.26 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $54.95 Typical High $72.44 | Professional | None | $52.48 | $54.95 | $72.44 |
Ambetter Setting Professional Modifier None Typical Low $39.81 Median $77.62 Typical High $138.04 | Professional | None | $39.81 | $77.62 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $478.63 | Facility | None | $102.33 | $102.33 | $478.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $61.66 Typical High $83.18 | Professional | None | $58.88 | $61.66 | $83.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $43.65 Median $45.71 Typical High $70.79 | Professional | UE · Used equipment | $43.65 | $45.71 | $70.79 |
BCBS Kansas City Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $102.33 | Professional | None | $61.66 | $61.66 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $75.86 | Facility | None | $67.61 | $67.61 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | None | $50.12 | $50.12 | $67.61 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $104.71 Typical High $537.03 | Facility | None | $54.95 | $104.71 | $537.03 |
Medica Setting Professional Modifier None Typical Low $41.69 Median $50.12 Typical High $831.76 | Professional | None | $41.69 | $50.12 | $831.76 |
United Setting Facility Modifier None Typical Low $67.61 Median $77.62 Typical High $138.04 | Facility | None | $67.61 | $77.62 | $138.04 |
United Setting Professional Modifier None Typical Low $38.02 Median $50.12 Typical High $77.62 | Professional | None | $38.02 | $50.12 | $77.62 |
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 $26.30 Median $27.54 Typical High $30.90 | Professional | 52 · Reduced service | $26.30 | $27.54 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.96 Typical High $12.30 | Professional | 53 · Discontinued | $10.47 | $10.96 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $8.32 Typical High $9.33 | Professional | 55 · Aftercare only | $7.94 | $8.32 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.50 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.25 | $5.50 | $6.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.17 Median $6.17 Typical High $63.10 | Professional | RR · Rental | $6.17 | $6.17 | $63.10 |
Where Missouri sits
The same service costs 4.1 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· 36th of 51
$61.66
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.