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 $213.80 Median $316.23 Typical High $316.23 | Facility | None | $213.80 | $316.23 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $316.23 Typical High $446.68 | Professional | None | $213.80 | $316.23 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $2,187.76 | Facility | None | $478.63 | $478.63 | $2,187.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $281.84 Typical High $380.19 | Professional | None | $208.93 | $281.84 | $380.19 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $158.49 Median $162.18 Typical High $331.13 | Professional | UE · Used equipment | $158.49 | $162.18 | $331.13 |
BCBS Kansas City Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $478.63 | Professional | None | $288.40 | $288.40 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $269.15 | Facility | None | $245.47 | $245.47 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
Medica Setting Facility Modifier None Typical Low $194.98 Median $426.58 Typical High $1,862.09 | Facility | None | $194.98 | $426.58 | $1,862.09 |
Medica Setting Professional Modifier None Typical Low $154.88 Median $234.42 Typical High $2,630.27 | Professional | None | $154.88 | $234.42 | $2,630.27 |
United Setting Facility Modifier None Typical Low $234.42 Median $281.84 Typical High $478.63 | Facility | None | $234.42 | $281.84 | $478.63 |
United Setting Professional Modifier None Typical Low $144.54 Median $234.42 Typical High $309.03 | Professional | None | $144.54 | $234.42 | $309.03 |
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 $107.15 Median $158.49 Typical High $223.87 | Professional | 52 · Reduced service | $107.15 | $158.49 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $63.10 Typical High $89.13 | Professional | 53 · Discontinued | $42.66 | $63.10 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $47.86 Typical High $66.07 | Professional | 55 · Aftercare only | $32.36 | $47.86 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $31.62 Typical High $44.67 | Professional | 56 · Pre-op care only | $21.38 | $31.62 | $44.67 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.88 Median $21.88 Typical High $218.78 | Professional | RR · Rental | $21.88 | $21.88 | $218.78 |
Where Missouri sits
The same service costs 3.6 times more in Hawaii than in Tennessee. 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· 25th of 51
$245
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.