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 $107.15 Median $158.49 Typical High $158.49 | Facility | None | $107.15 | $158.49 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $158.49 Typical High $223.87 | Professional | None | $107.15 | $158.49 | $223.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $1,096.48 | Facility | None | $239.88 | $239.88 | $1,096.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $190.55 | Professional | None | $114.82 | $144.54 | $190.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $87.10 Median $89.13 Typical High $165.96 | Professional | UE · Used equipment | $87.10 | $89.13 | $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 $125.89 Median $125.89 Typical High $141.25 | Facility | None | $125.89 | $125.89 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | None | $93.33 | $93.33 | $125.89 |
Medica Setting Facility Modifier None Typical Low $107.15 Median $223.87 Typical High $1,047.13 | Facility | None | $107.15 | $223.87 | $1,047.13 |
Medica Setting Professional Modifier None Typical Low $79.43 Median $117.49 Typical High $1,230.27 | Professional | None | $79.43 | $117.49 | $1,230.27 |
United Setting Facility Modifier None Typical Low $100.00 Median $120.23 Typical High $263.03 | Facility | None | $100.00 | $120.23 | $263.03 |
United Setting Professional Modifier None Typical Low $77.62 Median $117.49 Typical High $165.96 | Professional | None | $77.62 | $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 $21.38 Median $31.62 Typical High $44.67 | Professional | 53 · Discontinued | $21.38 | $31.62 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $23.99 Typical High $33.11 | Professional | 55 · Aftercare only | $16.22 | $23.99 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $15.85 Typical High $22.39 | Professional | 56 · Pre-op care only | $10.72 | $15.85 | $22.39 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.75 Median $11.75 Typical High $117.49 | Professional | RR · Rental | $11.75 | $11.75 | $117.49 |
Where Missouri sits
The same service costs 2.9 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· 30th of 51
$126
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.