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 $239.88 Median $354.81 Typical High $354.81 | Facility | None | $239.88 | $354.81 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $501.19 | Professional | None | $239.88 | $354.81 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $2,454.71 | Facility | None | $537.03 | $537.03 | $2,454.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $323.59 Typical High $436.52 | Professional | None | $263.03 | $323.59 | $436.52 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $194.98 Median $199.53 Typical High $371.54 | Professional | UE · Used equipment | $194.98 | $199.53 | $371.54 |
BCBS Kansas City Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $537.03 | Professional | None | $323.59 | $323.59 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $407.38 | Facility | None | $363.08 | $363.08 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $363.08 | Professional | None | $269.15 | $269.15 | $363.08 |
Medica Setting Facility Modifier None Typical Low $239.88 Median $501.19 Typical High $2,344.23 | Facility | None | $239.88 | $501.19 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $263.03 Typical High $2,884.03 | Professional | None | $181.97 | $263.03 | $2,884.03 |
United Setting Facility Modifier None Typical Low $165.96 Median $223.87 Typical High $588.84 | Facility | None | $165.96 | $223.87 | $588.84 |
United Setting Professional Modifier None Typical Low $173.78 Median $263.03 Typical High $354.81 | Professional | None | $173.78 | $263.03 | $354.81 |
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 $120.23 Median $177.83 Typical High $251.19 | Professional | 52 · Reduced service | $120.23 | $177.83 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $70.79 Typical High $100.00 | Professional | 53 · Discontinued | $47.86 | $70.79 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $53.70 Typical High $75.86 | Professional | 55 · Aftercare only | $36.31 | $53.70 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $35.48 Typical High $50.12 | Professional | 56 · Pre-op care only | $23.99 | $35.48 | $50.12 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $26.92 Median $26.92 Typical High $269.15 | Professional | RR · Rental | $26.92 | $26.92 | $269.15 |
Where Missouri sits
The same service costs 2.2 times more in Wisconsin 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· 28th of 51
$302
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.