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 $109.65 Median $162.18 Typical High $162.18 | Facility | None | $109.65 | $162.18 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $162.18 Typical High $223.87 | Professional | None | $109.65 | $162.18 | $223.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $1,122.02 | Facility | None | $239.88 | $239.88 | $1,122.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $138.04 Typical High $194.98 | Professional | None | $125.89 | $138.04 | $194.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $95.50 Median $95.50 Typical High $165.96 | Professional | UE · Used equipment | $95.50 | $95.50 | $165.96 |
BCBS Kansas City Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $239.88 | Professional | None | $144.54 | $144.54 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $186.21 | Facility | None | $165.96 | $165.96 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | None | $120.23 | $120.23 | $165.96 |
Medica Setting Facility Modifier None Typical Low $109.65 Median $229.09 Typical High $1,122.02 | Facility | None | $109.65 | $229.09 | $1,122.02 |
Medica Setting Professional Modifier None Typical Low $87.10 Median $120.23 Typical High $1,348.96 | Professional | None | $87.10 | $120.23 | $1,348.96 |
United Setting Facility Modifier None Typical Low $138.04 Median $141.25 Typical High $288.40 | Facility | None | $138.04 | $141.25 | $288.40 |
United Setting Professional Modifier None Typical Low $83.18 Median $117.49 Typical High $165.96 | Professional | None | $83.18 | $117.49 | $165.96 |
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 $53.70 Median $79.43 Typical High $112.20 | Professional | 52 · Reduced service | $53.70 | $79.43 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $32.36 Typical High $45.71 | Professional | 53 · Discontinued | $21.88 | $32.36 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $23.99 Typical High $33.88 | Professional | 55 · Aftercare only | $16.22 | $23.99 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $16.22 Typical High $22.39 | Professional | 56 · Pre-op care only | $10.96 | $16.22 | $22.39 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.59 Median $12.59 Typical High $125.89 | Professional | RR · Rental | $12.59 | $12.59 | $125.89 |
Where Missouri sits
The same service costs 2.8 times more in Hawaii than in Florida. 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
$132
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.