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 $338.84 Median $501.19 Typical High $501.19 | Facility | None | $338.84 | $501.19 | $501.19 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $501.19 Typical High $707.95 | Professional | None | $338.84 | $501.19 | $707.95 |
Ambetter Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $3,548.13 | Facility | None | $758.58 | $758.58 | $3,548.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $436.52 Typical High $616.60 | Professional | None | $380.19 | $436.52 | $616.60 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $281.84 Median $288.40 Typical High $524.81 | Professional | UE · Used equipment | $281.84 | $288.40 | $524.81 |
BCBS Kansas City Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $758.58 | Professional | None | $457.09 | $457.09 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $436.52 | Facility | None | $398.11 | $398.11 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $398.11 | Professional | None | $288.40 | $288.40 | $398.11 |
Medica Setting Facility Modifier None Typical Low $338.84 Median $707.95 Typical High $3,311.31 | Facility | None | $338.84 | $707.95 | $3,311.31 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $371.54 Typical High $3,630.78 | Professional | None | $263.03 | $371.54 | $3,630.78 |
United Setting Facility Modifier None Typical Low $363.08 Median $851.14 Typical High $851.14 | Facility | None | $363.08 | $851.14 | $851.14 |
United Setting Professional Modifier None Typical Low $245.47 Median $371.54 Typical High $501.19 | Professional | None | $245.47 | $371.54 | $501.19 |
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 $169.82 Median $251.19 Typical High $354.81 | Professional | 52 · Reduced service | $169.82 | $251.19 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $100.00 Typical High $141.25 | Professional | 53 · Discontinued | $67.61 | $100.00 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $75.86 Typical High $107.15 | Professional | 55 · Aftercare only | $51.29 | $75.86 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $50.12 Typical High $70.79 | Professional | 56 · Pre-op care only | $33.88 | $50.12 | $70.79 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $38.02 Median $38.02 Typical High $380.19 | Professional | RR · Rental | $38.02 | $38.02 | $380.19 |
Where Missouri sits
The same service costs 2.8 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
$398
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.