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 $346.74 Median $363.08 Typical High $478.63 | Professional | None | $346.74 | $363.08 | $478.63 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $257.04 Median $269.15 Typical High $407.38 | Professional | UE · Used equipment | $257.04 | $269.15 | $407.38 |
BCBS Kansas City Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $602.56 | Professional | None | $354.81 | $354.81 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $537.03 | Facility | None | $501.19 | $501.19 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $501.19 | Professional | None | $371.54 | $371.54 | $501.19 |
Medica Setting Facility Modifier None Typical Low $269.15 Median $575.44 Typical High $3,090.30 | Facility | None | $269.15 | $575.44 | $3,090.30 |
Medica Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $3,890.45 | Professional | None | $245.47 | $316.23 | $3,890.45 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $794.33 | Facility | None | $389.05 | $389.05 | $794.33 |
United Setting Professional Modifier None Typical Low $223.87 Median $288.40 Typical High $446.68 | Professional | None | $223.87 | $288.40 | $446.68 |
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 $275.42 | Professional | 52 · Reduced service | $134.90 | $199.53 | $275.42 |
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 $39.81 Median $58.88 Typical High $83.18 | Professional | 55 · Aftercare only | $39.81 | $58.88 | $83.18 |
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 $35.48 Median $35.48 Typical High $354.81 | Professional | RR · Rental | $35.48 | $35.48 | $354.81 |
Where Missouri sits
The same service costs 3.0 times more in Hawaii than in Washington, DC. 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· 44th of 51
$363
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.