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 $407.38 Median $602.56 Typical High $602.56 | Facility | None | $407.38 | $602.56 | $602.56 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $602.56 Typical High $851.14 | Professional | None | $407.38 | $602.56 | $851.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $4,168.69 | Facility | None | $912.01 | $912.01 | $4,168.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $537.03 Typical High $724.44 | Professional | None | $512.86 | $537.03 | $724.44 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $371.54 Median $389.05 Typical High $630.96 | Professional | UE · Used equipment | $371.54 | $389.05 | $630.96 |
BCBS Kansas City Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $912.01 | Professional | None | $537.03 | $537.03 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $645.65 | Facility | None | $588.84 | $588.84 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $588.84 | Professional | None | $426.58 | $426.58 | $588.84 |
Medica Setting Facility Modifier None Typical Low $407.38 Median $891.25 Typical High $4,466.84 | Facility | None | $407.38 | $891.25 | $4,466.84 |
Medica Setting Professional Modifier None Typical Low $354.81 Median $478.63 Typical High $5,754.40 | Professional | None | $354.81 | $478.63 | $5,754.40 |
United Setting Facility Modifier None Typical Low $501.19 Median $524.81 Typical High $1,174.90 | Facility | None | $501.19 | $524.81 | $1,174.90 |
United Setting Professional Modifier None Typical Low $338.84 Median $446.68 Typical High $660.69 | Professional | None | $338.84 | $446.68 | $660.69 |
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 $204.17 Median $302.00 Typical High $426.58 | Professional | 52 · Reduced service | $204.17 | $302.00 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $120.23 Typical High $169.82 | Professional | 53 · Discontinued | $81.28 | $120.23 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $89.13 Typical High $125.89 | Professional | 55 · Aftercare only | $60.26 | $89.13 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $60.26 Typical High $85.11 | Professional | 56 · Pre-op care only | $40.74 | $60.26 | $85.11 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $52.48 Median $52.48 Typical High $524.81 | Professional | RR · Rental | $52.48 | $52.48 | $524.81 |
Where Missouri sits
The same service costs 2.8 times more in Hawaii than in West Virginia. 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· 34th of 51
$537
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.