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 $87.10 Median $128.82 Typical High $128.82 | Facility | None | $87.10 | $128.82 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $128.82 Typical High $181.97 | Professional | None | $87.10 | $128.82 | $181.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $891.25 | Facility | None | $194.98 | $194.98 | $891.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $117.49 Typical High $158.49 | Professional | None | $95.50 | $117.49 | $158.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $72.44 Median $72.44 Typical High $134.90 | Professional | UE · Used equipment | $72.44 | $72.44 | $134.90 |
BCBS Kansas City Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $194.98 | Professional | None | $117.49 | $117.49 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $109.65 | Facility | None | $100.00 | $100.00 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $100.00 | Professional | None | $72.44 | $72.44 | $100.00 |
Medica Setting Facility Modifier None Typical Low $87.10 Median $186.21 Typical High $831.76 | Facility | None | $87.10 | $186.21 | $831.76 |
Medica Setting Professional Modifier None Typical Low $66.07 Median $95.50 Typical High $1,174.90 | Professional | None | $66.07 | $95.50 | $1,174.90 |
United Setting Facility Modifier None Typical Low $102.33 Median $107.15 Typical High $218.78 | Facility | None | $102.33 | $107.15 | $218.78 |
United Setting Professional Modifier None Typical Low $63.10 Median $95.50 Typical High $134.90 | Professional | None | $63.10 | $95.50 | $134.90 |
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 $43.65 Median $64.57 Typical High $91.20 | Professional | 52 · Reduced service | $43.65 | $64.57 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $25.70 Typical High $36.31 | Professional | 53 · Discontinued | $17.38 | $25.70 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $19.50 Typical High $27.54 | Professional | 55 · Aftercare only | $13.18 | $19.50 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $12.88 Typical High $18.20 | Professional | 56 · Pre-op care only | $8.71 | $12.88 | $18.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.55 Median $9.55 Typical High $95.50 | Professional | RR · Rental | $9.55 | $9.55 | $95.50 |
Where Missouri sits
The same service costs 4.1 times more in Hawaii than in Delaware. 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· 27th of 51
$105
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.