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 $371.54 Median $549.54 Typical High $549.54 | Facility | None | $371.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $549.54 Typical High $776.25 | Professional | None | $371.54 | $549.54 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $3,801.89 | Facility | None | $831.76 | $831.76 | $3,801.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $660.69 | Professional | None | $416.87 | $501.19 | $660.69 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $309.03 Median $309.03 Typical High $575.44 | Professional | UE · Used equipment | $309.03 | $309.03 | $575.44 |
BCBS Kansas City Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $831.76 | Professional | None | $489.78 | $489.78 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $549.54 | Facility | None | $501.19 | $501.19 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $501.19 | Professional | None | $363.08 | $363.08 | $501.19 |
Medica Setting Facility Modifier None Typical Low $371.54 Median $776.25 Typical High $3,715.35 | Facility | None | $371.54 | $776.25 | $3,715.35 |
Medica Setting Professional Modifier None Typical Low $288.40 Median $407.38 Typical High $4,570.88 | Professional | None | $288.40 | $407.38 | $4,570.88 |
United Setting Facility Modifier None Typical Low $426.58 Median $467.74 Typical High $933.25 | Facility | None | $426.58 | $467.74 | $933.25 |
United Setting Professional Modifier None Typical Low $269.15 Median $407.38 Typical High $562.34 | Professional | None | $269.15 | $407.38 | $562.34 |
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 $186.21 Median $275.42 Typical High $389.05 | Professional | 52 · Reduced service | $186.21 | $275.42 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $109.65 Typical High $154.88 | Professional | 53 · Discontinued | $74.13 | $109.65 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $81.28 Typical High $114.82 | Professional | 55 · Aftercare only | $54.95 | $81.28 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $54.95 Typical High $77.62 | Professional | 56 · Pre-op care only | $37.15 | $54.95 | $77.62 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $41.69 Median $41.69 Typical High $416.87 | Professional | RR · Rental | $41.69 | $41.69 | $416.87 |
Where Missouri sits
The same service costs 3.0 times more in Hawaii than in West Virginia. 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· 29th of 51
$457
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.