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 $173.78 Median $257.04 Typical High $257.04 | Facility | None | $173.78 | $257.04 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $257.04 Typical High $363.08 | Professional | None | $173.78 | $257.04 | $363.08 |
Ambetter Setting Professional Modifier None Typical Low $263.03 Median $295.12 Typical High $295.12 | Professional | None | $263.03 | $295.12 | $295.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $1,778.28 | Facility | None | $389.05 | $389.05 | $1,778.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $234.42 Typical High $316.23 | Professional | None | $223.87 | $234.42 | $316.23 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $162.18 Median $173.78 Typical High $269.15 | Professional | UE · Used equipment | $162.18 | $173.78 | $269.15 |
BCBS Kansas City Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $389.05 | Professional | None | $234.42 | $234.42 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $275.42 | Facility | None | $245.47 | $245.47 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $245.47 | Professional | None | $181.97 | $181.97 | $245.47 |
Medica Setting Facility Modifier None Typical Low $173.78 Median $380.19 Typical High $1,995.26 | Facility | None | $173.78 | $380.19 | $1,995.26 |
Medica Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $2,511.89 | Professional | None | $158.49 | $213.80 | $2,511.89 |
United Setting Facility Modifier None Typical Low $190.55 Median $245.47 Typical High $512.86 | Facility | None | $190.55 | $245.47 | $512.86 |
United Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $295.12 | Professional | None | $144.54 | $190.55 | $295.12 |
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 $87.10 Median $128.82 Typical High $181.97 | Professional | 52 · Reduced service | $87.10 | $128.82 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $51.29 Typical High $72.44 | Professional | 53 · Discontinued | $34.67 | $51.29 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $38.90 Typical High $54.95 | Professional | 55 · Aftercare only | $26.30 | $38.90 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $25.70 Typical High $36.31 | Professional | 56 · Pre-op care only | $17.38 | $25.70 | $36.31 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $22.91 Median $22.91 Typical High $239.88 | Professional | RR · Rental | $22.91 | $22.91 | $239.88 |
Where Missouri sits
The same service costs 2.5 times more in Kansas than in Florida. 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· 42nd of 51
$234
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.