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 $269.15 Median $398.11 Typical High $398.11 | Facility | None | $269.15 | $398.11 | $398.11 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $398.11 Typical High $562.34 | Professional | None | $269.15 | $398.11 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $2,754.23 | Facility | None | $602.56 | $602.56 | $2,754.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $346.74 Typical High $489.78 | Professional | None | $295.12 | $346.74 | $489.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $218.78 Median $223.87 Typical High $416.87 | Professional | UE · Used equipment | $218.78 | $223.87 | $416.87 |
BCBS Kansas City Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $602.56 | Professional | None | $363.08 | $363.08 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $338.84 | Facility | None | $309.03 | $309.03 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $309.03 | Professional | None | $223.87 | $223.87 | $309.03 |
Medica Setting Facility Modifier None Typical Low $269.15 Median $575.44 Typical High $2,511.89 | Facility | None | $269.15 | $575.44 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $204.17 Median $295.12 Typical High $3,235.94 | Professional | None | $204.17 | $295.12 | $3,235.94 |
United Setting Facility Modifier None Typical Low $138.04 Median $245.47 Typical High $660.69 | Facility | None | $138.04 | $245.47 | $660.69 |
United Setting Professional Modifier None Typical Low $194.98 Median $295.12 Typical High $416.87 | Professional | None | $194.98 | $295.12 | $416.87 |
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 $134.90 Median $199.53 Typical High $281.84 | Professional | 52 · Reduced service | $134.90 | $199.53 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $79.43 Typical High $112.20 | Professional | 53 · Discontinued | $53.70 | $79.43 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $60.26 Typical High $85.11 | Professional | 55 · Aftercare only | $40.74 | $60.26 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $39.81 Typical High $56.23 | Professional | 56 · Pre-op care only | $26.92 | $39.81 | $56.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $29.51 Median $29.51 Typical High $295.12 | Professional | RR · Rental | $29.51 | $29.51 | $295.12 |
Where Missouri sits
The same service costs 2.7 times more in Montana 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· 29th of 51
$309
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.