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 $870.96 Median $1,288.25 Typical High $1,288.25 | Facility | None | $870.96 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $1,288.25 Typical High $1,819.70 | Professional | None | $870.96 | $1,288.25 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $8,912.51 | Facility | None | $1,949.84 | $1,949.84 | $8,912.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,148.15 Typical High $1,548.82 | Professional | None | $1,096.48 | $1,148.15 | $1,548.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $812.83 Median $851.14 Typical High $1,348.96 | Professional | UE · Used equipment | $812.83 | $851.14 | $1,348.96 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,949.84 | Professional | None | $1,174.90 | $1,174.90 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,513.56 | Facility | None | $1,412.54 | $1,412.54 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,412.54 | Professional | None | $1,023.29 | $1,023.29 | $1,412.54 |
Medica Setting Facility Modifier None Typical Low $870.96 Median $1,862.09 Typical High $10,000.00 | Facility | None | $870.96 | $1,862.09 | $10,000.00 |
Medica Setting Professional Modifier None Typical Low $758.58 Median $1,023.29 Typical High $14,125.38 | Professional | None | $758.58 | $1,023.29 | $14,125.38 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,318.26 Typical High $2,511.89 | Facility | None | $1,230.27 | $1,318.26 | $2,511.89 |
United Setting Professional Modifier None Typical Low $724.44 Median $954.99 Typical High $1,412.54 | Professional | None | $724.44 | $954.99 | $1,412.54 |
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 $436.52 Median $645.65 Typical High $912.01 | Professional | 52 · Reduced service | $436.52 | $645.65 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $257.04 Typical High $363.08 | Professional | 53 · Discontinued | $173.78 | $257.04 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $194.98 Typical High $275.42 | Professional | 55 · Aftercare only | $131.83 | $194.98 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $128.82 Typical High $181.97 | Professional | 56 · Pre-op care only | $87.10 | $128.82 | $181.97 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $112.20 Median $112.20 Typical High $1,122.02 | Professional | RR · Rental | $112.20 | $112.20 | $1,122.02 |
Where Missouri sits
The same service costs 3.6 times more in Hawaii than in Washington, DC. 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· 32nd of 51
$1,148
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.