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 $38.90 Median $57.54 Typical High $57.54 | Facility | None | $38.90 | $57.54 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $57.54 Typical High $81.28 | Professional | None | $38.90 | $57.54 | $81.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $407.38 | Facility | None | $87.10 | $87.10 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $53.70 Typical High $70.79 | Professional | None | $46.77 | $53.70 | $70.79 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $35.48 Median $39.81 Typical High $60.26 | Professional | UE · Used equipment | $35.48 | $39.81 | $60.26 |
BCBS Kansas City Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $87.10 | Professional | None | $52.48 | $52.48 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $53.70 | Facility | None | $48.98 | $48.98 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $48.98 | Professional | None | $35.48 | $35.48 | $48.98 |
Medica Setting Facility Modifier None Typical Low $38.90 Median $77.62 Typical High $407.38 | Facility | None | $38.90 | $77.62 | $407.38 |
Medica Setting Professional Modifier None Typical Low $32.36 Median $43.65 Typical High $512.86 | Professional | None | $32.36 | $43.65 | $512.86 |
United Setting Facility Modifier None Typical Low $19.95 Median $39.81 Typical High $107.15 | Facility | None | $19.95 | $39.81 | $107.15 |
United Setting Professional Modifier None Typical Low $30.20 Median $42.66 Typical High $60.26 | Professional | None | $30.20 | $42.66 | $60.26 |
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 $19.50 Median $28.84 Typical High $40.74 | Professional | 52 · Reduced service | $19.50 | $28.84 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $11.75 Typical High $16.22 | Professional | 53 · Discontinued | $7.94 | $11.75 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $8.71 Typical High $12.30 | Professional | 55 · Aftercare only | $5.89 | $8.71 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $5.75 Typical High $8.13 | Professional | 56 · Pre-op care only | $3.89 | $5.75 | $8.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.37 Median $5.37 Typical High $53.70 | Professional | RR · Rental | $5.37 | $5.37 | $53.70 |
Where Missouri sits
The same service costs 2.8 times more in Montana than in New Jersey. 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· 31st of 51
$52.48
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.