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 $223.87 Median $331.13 Typical High $331.13 | Facility | None | $223.87 | $331.13 | $331.13 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $331.13 Typical High $467.74 | Professional | None | $223.87 | $331.13 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $2,290.87 | Facility | None | $501.19 | $501.19 | $2,290.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $257.04 Median $302.00 Typical High $398.11 | Professional | None | $257.04 | $302.00 | $398.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $194.98 Median $199.53 Typical High $346.74 | Professional | UE · Used equipment | $194.98 | $199.53 | $346.74 |
BCBS Kansas City Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $501.19 | Professional | None | $302.00 | $302.00 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $302.00 | Facility | None | $281.84 | $281.84 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $281.84 | Professional | None | $204.17 | $204.17 | $281.84 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $489.78 Typical High $2,344.23 | Facility | None | $223.87 | $489.78 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $3,388.44 | Professional | None | $177.83 | $245.47 | $3,388.44 |
United Setting Facility Modifier None Typical Low $288.40 Median $389.05 Typical High $588.84 | Facility | None | $288.40 | $389.05 | $588.84 |
United Setting Professional Modifier None Typical Low $169.82 Median $245.47 Typical High $346.74 | Professional | None | $169.82 | $245.47 | $346.74 |
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 $112.20 Median $165.96 Typical High $234.42 | Professional | 52 · Reduced service | $112.20 | $165.96 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $66.07 Typical High $93.33 | Professional | 53 · Discontinued | $44.67 | $66.07 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $50.12 Typical High $69.18 | Professional | 55 · Aftercare only | $33.88 | $50.12 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $33.11 Typical High $46.77 | Professional | 56 · Pre-op care only | $22.39 | $33.11 | $46.77 |
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 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
$282
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.