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 $89.13 Median $131.83 Typical High $131.83 | Facility | None | $89.13 | $131.83 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $131.83 Typical High $186.21 | Professional | None | $89.13 | $131.83 | $186.21 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $912.01 | Facility | None | $199.53 | $199.53 | $912.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $120.23 Typical High $162.18 | Professional | None | $114.82 | $120.23 | $162.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $83.18 Median $89.13 Typical High $138.04 | Professional | UE · Used equipment | $83.18 | $89.13 | $138.04 |
BCBS Kansas City Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $199.53 | Professional | None | $120.23 | $120.23 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $134.90 | Facility | None | $123.03 | $123.03 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $123.03 | Professional | None | $89.13 | $89.13 | $123.03 |
Medica Setting Facility Modifier None Typical Low $89.13 Median $194.98 Typical High $1,047.13 | Facility | None | $89.13 | $194.98 | $1,047.13 |
Medica Setting Professional Modifier None Typical Low $81.28 Median $109.65 Typical High $1,288.25 | Professional | None | $81.28 | $109.65 | $1,288.25 |
United Setting Facility Modifier None Typical Low $107.15 Median $131.83 Typical High $269.15 | Facility | None | $107.15 | $131.83 | $269.15 |
United Setting Professional Modifier None Typical Low $74.13 Median $97.72 Typical High $151.36 | Professional | None | $74.13 | $97.72 | $151.36 |
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 $44.67 Median $66.07 Typical High $93.33 | Professional | 52 · Reduced service | $44.67 | $66.07 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $26.30 Typical High $37.15 | Professional | 53 · Discontinued | $17.78 | $26.30 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $19.95 Typical High $28.18 | Professional | 55 · Aftercare only | $13.49 | $19.95 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $13.18 Typical High $18.62 | Professional | 56 · Pre-op care only | $8.91 | $13.18 | $18.62 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.02 Median $12.02 Typical High $120.23 | Professional | RR · Rental | $12.02 | $12.02 | $120.23 |
Where Missouri sits
The same service costs 3.0 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· 36th of 51
$120
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.