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 $331.13 Median $489.78 Typical High $489.78 | Facility | None | $331.13 | $489.78 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $489.78 Typical High $676.08 | Professional | None | $331.13 | $489.78 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $3,388.44 | Facility | None | $724.44 | $724.44 | $3,388.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $588.84 | Professional | None | $363.08 | $446.68 | $588.84 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $269.15 Median $275.42 Typical High $501.19 | Professional | UE · Used equipment | $269.15 | $275.42 | $501.19 |
BCBS Kansas City Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $724.44 | Professional | None | $436.52 | $436.52 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $457.09 | Facility | None | $426.58 | $426.58 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $426.58 | Professional | None | $309.03 | $309.03 | $426.58 |
Medica Setting Facility Modifier None Typical Low $331.13 Median $676.08 Typical High $3,235.94 | Facility | None | $331.13 | $676.08 | $3,235.94 |
Medica Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $3,981.07 | Professional | None | $251.19 | $363.08 | $3,981.07 |
United Setting Facility Modifier None Typical Low $338.84 Median $380.19 Typical High $812.83 | Facility | None | $338.84 | $380.19 | $812.83 |
United Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $501.19 | Professional | None | $239.88 | $354.81 | $501.19 |
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 $239.88 Typical High $338.84 | Professional | 52 · Reduced service | $162.18 | $239.88 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $97.72 Typical High $138.04 | Professional | 53 · Discontinued | $66.07 | $97.72 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $72.44 Typical High $102.33 | Professional | 55 · Aftercare only | $48.98 | $72.44 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $48.98 Typical High $67.61 | Professional | 56 · Pre-op care only | $33.11 | $48.98 | $67.61 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $37.15 Median $37.15 Typical High $371.54 | Professional | RR · Rental | $37.15 | $37.15 | $371.54 |
Where Missouri sits
The same service costs 2.7 times more in Hawaii than in Kansas. 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
$407
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.