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 $194.98 Median $288.40 Typical High $288.40 | Facility | None | $194.98 | $288.40 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $288.40 Typical High $407.38 | Professional | None | $194.98 | $288.40 | $407.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $1,995.26 | Facility | None | $436.52 | $436.52 | $1,995.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $263.03 Typical High $346.74 | Professional | None | $239.88 | $263.03 | $346.74 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $177.83 Median $181.97 Typical High $302.00 | Professional | UE · Used equipment | $177.83 | $181.97 | $302.00 |
BCBS Kansas City Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $436.52 | Professional | None | $263.03 | $263.03 | $436.52 |
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 $194.98 Median $416.87 Typical High $2,089.30 | Facility | None | $194.98 | $416.87 | $2,089.30 |
Medica Setting Professional Modifier None Typical Low $165.96 Median $229.09 Typical High $2,344.23 | Professional | None | $165.96 | $229.09 | $2,344.23 |
United Setting Facility Modifier None Typical Low $218.78 Median $245.47 Typical High $537.03 | Facility | None | $218.78 | $245.47 | $537.03 |
United Setting Professional Modifier None Typical Low $154.88 Median $213.80 Typical High $309.03 | Professional | None | $154.88 | $213.80 | $309.03 |
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 $97.72 Median $144.54 Typical High $204.17 | Professional | 52 · Reduced service | $97.72 | $144.54 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $57.54 Typical High $81.28 | Professional | 53 · Discontinued | $38.90 | $57.54 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $42.66 Typical High $60.26 | Professional | 55 · Aftercare only | $28.84 | $42.66 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $28.84 Typical High $40.74 | Professional | 56 · Pre-op care only | $19.50 | $28.84 | $40.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $23.99 Median $23.99 Typical High $239.88 | Professional | RR · Rental | $23.99 | $23.99 | $239.88 |
Where Missouri sits
The same service costs 2.5 times more in Hawaii than in Pennsylvania. 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· 34th of 51
$245
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.