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 $46.77 Median $46.77 Typical High $53.70 | Facility | None | $46.77 | $46.77 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $48.98 Typical High $53.70 | Professional | None | $46.77 | $48.98 | $53.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $416.87 | Facility | None | $91.20 | $91.20 | $416.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $48.98 Median $54.95 Typical High $75.86 | Professional | None | $48.98 | $54.95 | $75.86 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $36.31 Median $37.15 Typical High $63.10 | Professional | UE · Used equipment | $36.31 | $37.15 | $63.10 |
BCBS Kansas City Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $91.20 | Professional | None | $54.95 | $54.95 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $64.57 | Facility | None | $56.23 | $56.23 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $56.23 | Professional | None | $41.69 | $41.69 | $56.23 |
Medica Setting Facility Modifier None Typical Low $46.77 Median $93.33 Typical High $436.52 | Facility | None | $46.77 | $93.33 | $436.52 |
Medica Setting Professional Modifier None Typical Low $34.67 Median $44.67 Typical High $467.74 | Professional | None | $34.67 | $44.67 | $467.74 |
United Setting Facility Modifier None Typical Low $44.67 Median $112.20 Typical High $112.20 | Facility | None | $44.67 | $112.20 | $112.20 |
United Setting Professional Modifier None Typical Low $31.62 Median $44.67 Typical High $67.61 | Professional | None | $31.62 | $44.67 | $67.61 |
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 $23.44 Median $24.55 Typical High $26.92 | Professional | 52 · Reduced service | $23.44 | $24.55 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.77 Typical High $10.72 | Professional | 53 · Discontinued | $9.33 | $9.77 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.41 Typical High $7.94 | Professional | 55 · Aftercare only | $7.08 | $7.41 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.90 Typical High $5.37 | Professional | 56 · Pre-op care only | $4.68 | $4.90 | $5.37 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.90 Median $4.90 Typical High $51.29 | Professional | RR · Rental | $4.90 | $4.90 | $51.29 |
Where Missouri sits
The same service costs 2.6 times more in Kansas than in Arizona. 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
$51.29
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.