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 $4,677.35 Median $6,918.31 Typical High $6,918.31 | Facility | None | $4,677.35 | $6,918.31 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $4,677.35 Median $6,918.31 Typical High $9,772.37 | Professional | None | $4,677.35 | $6,918.31 | $9,772.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,471.29 Median $10,471.29 Typical High $47,863.01 | Facility | None | $10,471.29 | $10,471.29 | $47,863.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $5,495.41 Median $5,623.41 Typical High $9,549.93 | Professional | None | $5,495.41 | $5,623.41 | $9,549.93 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4,168.69 Median $4,265.80 Typical High $7,244.36 | Professional | UE · Used equipment | $4,168.69 | $4,265.80 | $7,244.36 |
BCBS Kansas City Setting Professional Modifier None Typical Low $6,309.57 Median $6,309.57 Typical High $10,471.29 | Professional | None | $6,309.57 | $6,309.57 | $10,471.29 |
Cigna Setting Facility Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $7,079.46 | Facility | None | $6,606.93 | $6,606.93 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $6,606.93 | Professional | None | $4,897.79 | $4,897.79 | $6,606.93 |
Medica Setting Facility Modifier None Typical Low $4,677.35 Median $10,000.00 Typical High $47,863.01 | Facility | None | $4,677.35 | $10,000.00 | $47,863.01 |
Medica Setting Professional Modifier None Typical Low $3,801.89 Median $5,128.61 Typical High $51,286.14 | Professional | None | $3,801.89 | $5,128.61 | $51,286.14 |
United Setting Facility Modifier None Typical Low $12,589.25 Median $12,589.25 Typical High $12,589.25 | Facility | None | $12,589.25 | $12,589.25 | $12,589.25 |
United Setting Professional Modifier None Typical Low $3,630.78 Median $5,128.61 Typical High $7,244.36 | Professional | None | $3,630.78 | $5,128.61 | $7,244.36 |
3 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 55 · Aftercare only Typical Low $707.95 Median $1,047.13 Typical High $1,445.44 | Professional | 55 · Aftercare only | $707.95 | $1,047.13 | $1,445.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $467.74 Median $691.83 Typical High $977.24 | Professional | 56 · Pre-op care only | $467.74 | $691.83 | $977.24 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $562.34 Median $562.34 Typical High $5,623.41 | Professional | RR · Rental | $562.34 | $562.34 | $5,623.41 |
Where Missouri sits
The same service costs 2.3 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· 36th of 51
$5,623
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.