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 $1,819.70 Median $2,691.53 Typical High $2,691.53 | Facility | None | $1,819.70 | $2,691.53 | $2,691.53 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $2,691.53 Typical High $3,801.89 | Professional | None | $1,819.70 | $2,691.53 | $3,801.89 |
Ambetter Setting Professional Modifier None Typical Low $2,754.23 Median $3,090.30 Typical High $3,090.30 | Professional | None | $2,754.23 | $3,090.30 | $3,090.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $19,054.61 | Facility | None | $4,073.80 | $4,073.80 | $19,054.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,089.30 Median $2,454.71 Typical High $3,311.31 | Professional | None | $2,089.30 | $2,454.71 | $3,311.31 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,548.82 Median $1,621.81 Typical High $2,818.38 | Professional | UE · Used equipment | $1,548.82 | $1,621.81 | $2,818.38 |
BCBS Kansas City Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $4,073.80 | Professional | None | $2,454.71 | $2,454.71 | $4,073.80 |
Cigna Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,630.27 | Facility | None | $2,137.96 | $2,137.96 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $2,137.96 | Professional | None | $1,584.89 | $1,584.89 | $2,137.96 |
Medica Setting Facility Modifier None Typical Low $1,819.70 Median $3,801.89 Typical High $18,197.01 | Facility | None | $1,819.70 | $3,801.89 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $1,445.44 Median $1,995.26 Typical High $19,498.45 | Professional | None | $1,445.44 | $1,995.26 | $19,498.45 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $4,677.35 Typical High $4,677.35 | Facility | None | $1,949.84 | $4,677.35 | $4,677.35 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,995.26 Typical High $2,754.23 | Professional | None | $1,348.96 | $1,995.26 | $2,754.23 |
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 $912.01 Median $1,348.96 Typical High $1,905.46 | Professional | 52 · Reduced service | $912.01 | $1,348.96 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $537.03 Typical High $758.58 | Professional | 53 · Discontinued | $363.08 | $537.03 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $407.38 Typical High $575.44 | Professional | 55 · Aftercare only | $275.42 | $407.38 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $269.15 Typical High $380.19 | Professional | 56 · Pre-op care only | $181.97 | $269.15 | $380.19 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $213.80 Median $213.80 Typical High $2,187.76 | Professional | RR · Rental | $213.80 | $213.80 | $2,187.76 |
Where Missouri sits
The same service costs 2.6 times more in Wisconsin 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· 27th of 51
$2,291
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.