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 $741.31 Median $1,096.48 Typical High $1,096.48 | Facility | None | $741.31 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $1,096.48 Typical High $1,548.82 | Professional | None | $741.31 | $1,096.48 | $1,548.82 |
Ambetter Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $7,585.78 | Facility | None | $1,659.59 | $1,659.59 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $977.24 Typical High $1,318.26 | Professional | None | $870.96 | $977.24 | $1,318.26 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $645.65 Median $660.69 Typical High $1,148.15 | Professional | UE · Used equipment | $645.65 | $660.69 | $1,148.15 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,659.59 | Professional | None | $1,000.00 | $1,000.00 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $977.24 | Facility | None | $912.01 | $912.01 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $912.01 | Professional | None | $660.69 | $660.69 | $912.01 |
Medica Setting Facility Modifier None Typical Low $741.31 Median $1,621.81 Typical High $7,585.78 | Facility | None | $741.31 | $1,621.81 | $7,585.78 |
Medica Setting Professional Modifier None Typical Low $602.56 Median $812.83 Typical High $9,120.11 | Professional | None | $602.56 | $812.83 | $9,120.11 |
United Setting Facility Modifier None Typical Low $812.83 Median $954.99 Typical High $1,949.84 | Facility | None | $812.83 | $954.99 | $1,949.84 |
United Setting Professional Modifier None Typical Low $562.34 Median $812.83 Typical High $1,148.15 | Professional | None | $562.34 | $812.83 | $1,148.15 |
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 $371.54 Median $549.54 Typical High $776.25 | Professional | 52 · Reduced service | $371.54 | $549.54 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $218.78 Typical High $309.03 | Professional | 53 · Discontinued | $147.91 | $218.78 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $165.96 Typical High $234.42 | Professional | 55 · Aftercare only | $112.20 | $165.96 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $109.65 Typical High $154.88 | Professional | 56 · Pre-op care only | $74.13 | $109.65 | $154.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $87.10 Median $87.10 Typical High $870.96 | Professional | RR · Rental | $87.10 | $87.10 | $870.96 |
Where Missouri sits
The same service costs 3.2 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· 30th of 51
$912
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.