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 $102.33 Median $102.33 Typical High $117.49 | Facility | None | $102.33 | $102.33 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $107.15 Typical High $134.90 | Professional | None | $102.33 | $107.15 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $186.21 Typical High $239.88 | Professional | None | $147.91 | $186.21 | $239.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $912.01 | Facility | None | $199.53 | $199.53 | $912.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $117.49 Typical High $169.82 | Professional | None | $91.20 | $117.49 | $169.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.48 Median $11.48 Typical High $120.23 | Professional | RR · Rental | $11.48 | $11.48 | $120.23 |
BCBS Kansas City Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $199.53 | Professional | None | $117.49 | $117.49 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $125.89 Typical High $141.25 | Facility | None | $107.15 | $125.89 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $107.15 | Professional | None | $93.33 | $93.33 | $107.15 |
Cigna Setting Professional Modifier RR · Rental Typical Low $10.72 Median $10.72 Typical High $12.59 | Professional | RR · Rental | $10.72 | $10.72 | $12.59 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $194.98 Typical High $933.25 | Facility | None | $104.71 | $194.98 | $933.25 |
Medica Setting Professional Modifier None Typical Low $74.13 Median $97.72 Typical High $1,000.00 | Professional | None | $74.13 | $97.72 | $1,000.00 |
United Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
United Setting Professional Modifier None Typical Low $70.79 Median $97.72 Typical High $147.91 | Professional | None | $70.79 | $97.72 | $147.91 |
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 $51.29 Median $53.70 Typical High $57.54 | Professional | 52 · Reduced service | $51.29 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $21.38 Typical High $23.44 | Professional | 53 · Discontinued | $20.42 | $21.38 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.85 Typical High $17.38 | Professional | 55 · Aftercare only | $15.14 | $15.85 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.72 Typical High $11.75 | Professional | 56 · Pre-op care only | $10.23 | $10.72 | $11.75 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $85.11 Median $87.10 Typical High $144.54 | Professional | UE · Used equipment | $85.11 | $87.10 | $144.54 |
Where Missouri sits
The same service costs 2.1 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· 44th of 51
$110
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.