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 $107.15 Median $158.49 Typical High $158.49 | Facility | None | $107.15 | $158.49 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $158.49 Typical High $223.87 | Professional | None | $107.15 | $158.49 | $223.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $1,122.02 | Facility | None | $239.88 | $239.88 | $1,122.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $147.91 Typical High $194.98 | Professional | None | $134.90 | $147.91 | $194.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $100.00 Median $109.65 Typical High $151.36 | Professional | UE · Used equipment | $100.00 | $109.65 | $151.36 |
BCBS Kansas City Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $239.88 | Professional | None | $144.54 | $144.54 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $154.88 | Facility | None | $138.04 | $138.04 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $138.04 | Professional | None | $102.33 | $102.33 | $138.04 |
Medica Setting Facility Modifier None Typical Low $107.15 Median $229.09 Typical High $1,174.90 | Facility | None | $107.15 | $229.09 | $1,174.90 |
Medica Setting Professional Modifier None Typical Low $93.33 Median $125.89 Typical High $1,479.11 | Professional | None | $93.33 | $125.89 | $1,479.11 |
United Setting Facility Modifier None Typical Low $147.91 Median $154.88 Typical High $302.00 | Facility | None | $147.91 | $154.88 | $302.00 |
United Setting Professional Modifier None Typical Low $87.10 Median $117.49 Typical High $169.82 | Professional | None | $87.10 | $117.49 | $169.82 |
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 $53.70 Median $79.43 Typical High $112.20 | Professional | 52 · Reduced service | $53.70 | $79.43 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $32.36 Typical High $44.67 | Professional | 53 · Discontinued | $21.88 | $32.36 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $23.99 Typical High $33.88 | Professional | 55 · Aftercare only | $16.22 | $23.99 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $15.85 Typical High $22.39 | Professional | 56 · Pre-op care only | $10.72 | $15.85 | $22.39 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.49 Median $13.49 Typical High $134.90 | Professional | RR · Rental | $13.49 | $13.49 | $134.90 |
Where Missouri sits
The same service costs 3.5 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· 30th of 51
$138
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.