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 $354.81 Median $524.81 Typical High $524.81 | Facility | None | $354.81 | $524.81 | $524.81 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $524.81 Typical High $741.31 | Professional | None | $354.81 | $524.81 | $741.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $3,630.78 | Facility | None | $794.33 | $794.33 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $478.63 Typical High $630.96 | Professional | None | $389.05 | $478.63 | $630.96 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $295.12 Median $295.12 Typical High $549.54 | Professional | UE · Used equipment | $295.12 | $295.12 | $549.54 |
BCBS Kansas City Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $794.33 | Professional | None | $478.63 | $478.63 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $537.03 | Facility | None | $489.78 | $489.78 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $489.78 | Professional | None | $354.81 | $354.81 | $489.78 |
Medica Setting Facility Modifier None Typical Low $354.81 Median $741.31 Typical High $3,311.31 | Facility | None | $354.81 | $741.31 | $3,311.31 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $389.05 Typical High $4,365.16 | Professional | None | $269.15 | $389.05 | $4,365.16 |
United Setting Facility Modifier None Typical Low $165.96 Median $323.59 Typical High $891.25 | Facility | None | $165.96 | $323.59 | $891.25 |
United Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $549.54 | Professional | None | $257.04 | $389.05 | $549.54 |
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 $177.83 Median $263.03 Typical High $371.54 | Professional | 52 · Reduced service | $177.83 | $263.03 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $104.71 Typical High $147.91 | Professional | 53 · Discontinued | $70.79 | $104.71 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $79.43 Typical High $109.65 | Professional | 55 · Aftercare only | $53.70 | $79.43 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $52.48 Typical High $74.13 | Professional | 56 · Pre-op care only | $35.48 | $52.48 | $74.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $39.81 Median $39.81 Typical High $398.11 | Professional | RR · Rental | $39.81 | $39.81 | $398.11 |
Where Missouri sits
The same service costs 2.4 times more in Iowa 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· 26th of 51
$437
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.