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 $158.49 Median $234.42 Typical High $234.42 | Facility | None | $158.49 | $234.42 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $331.13 | Professional | None | $158.49 | $234.42 | $331.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $1,621.81 | Facility | None | $354.81 | $354.81 | $1,621.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $213.80 Typical High $281.84 | Professional | None | $204.17 | $213.80 | $281.84 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $151.36 Median $154.88 Typical High $245.47 | Professional | UE · Used equipment | $151.36 | $154.88 | $245.47 |
BCBS Kansas City Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $354.81 | Professional | None | $208.93 | $208.93 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $263.03 | Facility | None | $245.47 | $245.47 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
Medica Setting Facility Modifier None Typical Low $177.83 Median $346.74 Typical High $1,737.80 | Facility | None | $177.83 | $346.74 | $1,737.80 |
Medica Setting Professional Modifier None Typical Low $141.25 Median $186.21 Typical High $2,137.96 | Professional | None | $141.25 | $186.21 | $2,137.96 |
United Setting Facility Modifier None Typical Low $169.82 Median $173.78 Typical High $457.09 | Facility | None | $169.82 | $173.78 | $457.09 |
United Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $257.04 | Professional | None | $131.83 | $173.78 | $257.04 |
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 $79.43 Median $117.49 Typical High $165.96 | Professional | 52 · Reduced service | $79.43 | $117.49 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $46.77 Typical High $66.07 | Professional | 53 · Discontinued | $31.62 | $46.77 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $34.67 Typical High $48.98 | Professional | 55 · Aftercare only | $23.44 | $34.67 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $23.44 Typical High $33.11 | Professional | 56 · Pre-op care only | $15.85 | $23.44 | $33.11 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $20.42 Median $20.42 Typical High $204.17 | Professional | RR · Rental | $20.42 | $20.42 | $204.17 |
Where Missouri sits
The same service costs 2.3 times more in Wisconsin than in Colorado. 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· 34th of 51
$209
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.