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 $912.01 Median $1,348.96 Typical High $1,348.96 | Facility | None | $912.01 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,348.96 Typical High $1,905.46 | Professional | None | $912.01 | $1,348.96 | $1,905.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $9,549.93 | Facility | None | $2,041.74 | $2,041.74 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $1,659.59 | Professional | None | $1,122.02 | $1,258.93 | $1,659.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $851.14 Median $851.14 Typical High $1,412.54 | Professional | UE · Used equipment | $851.14 | $851.14 | $1,412.54 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $2,041.74 | Professional | None | $1,230.27 | $1,230.27 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,698.24 | Facility | None | $1,584.89 | $1,584.89 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,584.89 | Professional | None | $1,148.15 | $1,148.15 | $1,584.89 |
Medica Setting Facility Modifier None Typical Low $912.01 Median $1,949.84 Typical High $9,772.37 | Facility | None | $912.01 | $1,949.84 | $9,772.37 |
Medica Setting Professional Modifier None Typical Low $776.25 Median $1,047.13 Typical High $11,220.18 | Professional | None | $776.25 | $1,047.13 | $11,220.18 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,071.52 Typical High $2,570.40 | Facility | None | $794.33 | $1,071.52 | $2,570.40 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,000.00 Typical High $1,445.44 | Professional | None | $741.31 | $1,000.00 | $1,445.44 |
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 $457.09 Median $676.08 Typical High $954.99 | Professional | 52 · Reduced service | $457.09 | $676.08 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $275.42 Typical High $380.19 | Professional | 53 · Discontinued | $186.21 | $275.42 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $204.17 Typical High $288.40 | Professional | 55 · Aftercare only | $138.04 | $204.17 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $134.90 Typical High $190.55 | Professional | 56 · Pre-op care only | $91.20 | $134.90 | $190.55 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $114.82 Median $114.82 Typical High $1,148.15 | Professional | RR · Rental | $114.82 | $114.82 | $1,148.15 |
Where Missouri sits
The same service costs 2.3 times more in Wisconsin than in Washington, DC. 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
$1,230
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.