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 $389.05 Median $575.44 Typical High $575.44 | Facility | None | $389.05 | $575.44 | $575.44 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $575.44 Typical High $812.83 | Professional | None | $389.05 | $575.44 | $812.83 |
Ambetter Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $4,073.80 | Facility | None | $870.96 | $870.96 | $4,073.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $524.81 Typical High $707.95 | Professional | None | $457.09 | $524.81 | $707.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $338.84 Median $346.74 Typical High $602.56 | Professional | UE · Used equipment | $338.84 | $346.74 | $602.56 |
BCBS Kansas City Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $870.96 | Professional | None | $524.81 | $524.81 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $741.31 | Facility | None | $660.69 | $660.69 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $660.69 | Professional | None | $489.78 | $489.78 | $660.69 |
Medica Setting Facility Modifier None Typical Low $389.05 Median $812.83 Typical High $3,981.07 | Facility | None | $389.05 | $812.83 | $3,981.07 |
Medica Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $5,495.41 | Professional | None | $316.23 | $426.58 | $5,495.41 |
United Setting Facility Modifier None Typical Low $501.19 Median $549.54 Typical High $1,023.29 | Facility | None | $501.19 | $549.54 | $1,023.29 |
United Setting Professional Modifier None Typical Low $295.12 Median $426.58 Typical High $602.56 | Professional | None | $295.12 | $426.58 | $602.56 |
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 $194.98 Median $288.40 Typical High $407.38 | Professional | 52 · Reduced service | $194.98 | $288.40 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $114.82 Typical High $162.18 | Professional | 53 · Discontinued | $77.62 | $114.82 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $87.10 Typical High $123.03 | Professional | 55 · Aftercare only | $58.88 | $87.10 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $57.54 Typical High $81.28 | Professional | 56 · Pre-op care only | $38.90 | $57.54 | $81.28 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $45.71 Median $45.71 Typical High $478.63 | Professional | RR · Rental | $45.71 | $45.71 | $478.63 |
Where Missouri sits
The same service costs 4.1 times more in Hawaii than in Kansas. 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· 28th of 51
$501
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.