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 $70.79 Median $104.71 Typical High $104.71 | Facility | None | $70.79 | $104.71 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $104.71 Typical High $144.54 | Professional | None | $70.79 | $104.71 | $144.54 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $724.44 | Facility | None | $154.88 | $154.88 | $724.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $95.50 Typical High $125.89 | Professional | None | $91.20 | $95.50 | $125.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $64.57 Median $69.18 Typical High $107.15 | Professional | UE · Used equipment | $64.57 | $69.18 | $107.15 |
BCBS Kansas City Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $154.88 | Professional | None | $93.33 | $93.33 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $109.65 | Facility | None | $100.00 | $100.00 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $100.00 | Professional | None | $72.44 | $72.44 | $100.00 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $151.36 Typical High $794.33 | Facility | None | $70.79 | $151.36 | $794.33 |
Medica Setting Professional Modifier None Typical Low $64.57 Median $83.18 Typical High $1,023.29 | Professional | None | $64.57 | $83.18 | $1,023.29 |
United Setting Facility Modifier None Typical Low $60.26 Median $75.86 Typical High $208.93 | Facility | None | $60.26 | $75.86 | $208.93 |
United Setting Professional Modifier None Typical Low $58.88 Median $75.86 Typical High $117.49 | Professional | None | $58.88 | $75.86 | $117.49 |
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 $35.48 Median $51.29 Typical High $72.44 | Professional | 52 · Reduced service | $35.48 | $51.29 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $20.89 Typical High $29.51 | Professional | 53 · Discontinued | $14.13 | $20.89 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $15.49 Typical High $21.88 | Professional | 55 · Aftercare only | $10.47 | $15.49 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $10.47 Typical High $14.45 | Professional | 56 · Pre-op care only | $7.08 | $10.47 | $14.45 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.33 Median $9.33 Typical High $93.33 | Professional | RR · Rental | $9.33 | $9.33 | $93.33 |
Where Missouri sits
The same service costs 2.9 times more in Montana than in Florida. 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· 35th of 51
$93.33
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.