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 $316.23 Median $467.74 Typical High $467.74 | Facility | None | $316.23 | $467.74 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $467.74 Typical High $660.69 | Professional | None | $316.23 | $467.74 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $3,235.94 | Facility | None | $707.95 | $707.95 | $3,235.94 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $426.58 Typical High $562.34 | Professional | None | $407.38 | $426.58 | $562.34 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $295.12 Median $316.23 Typical High $489.78 | Professional | UE · Used equipment | $295.12 | $316.23 | $489.78 |
BCBS Kansas City Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $707.95 | Professional | None | $426.58 | $426.58 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $478.63 | Facility | None | $436.52 | $436.52 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $436.52 | Professional | None | $316.23 | $316.23 | $436.52 |
Medica Setting Facility Modifier None Typical Low $316.23 Median $676.08 Typical High $3,630.78 | Facility | None | $316.23 | $676.08 | $3,630.78 |
Medica Setting Professional Modifier None Typical Low $288.40 Median $371.54 Typical High $4,570.88 | Professional | None | $288.40 | $371.54 | $4,570.88 |
United Setting Facility Modifier None Typical Low $257.04 Median $346.74 Typical High $933.25 | Facility | None | $257.04 | $346.74 | $933.25 |
United Setting Professional Modifier None Typical Low $263.03 Median $346.74 Typical High $537.03 | Professional | None | $263.03 | $346.74 | $537.03 |
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 $158.49 Median $234.42 Typical High $331.13 | Professional | 52 · Reduced service | $158.49 | $234.42 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $93.33 Typical High $131.83 | Professional | 53 · Discontinued | $63.10 | $93.33 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $70.79 Typical High $97.72 | Professional | 55 · Aftercare only | $47.86 | $70.79 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $46.77 Typical High $66.07 | Professional | 56 · Pre-op care only | $31.62 | $46.77 | $66.07 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $41.69 Median $41.69 Typical High $416.87 | Professional | RR · Rental | $41.69 | $41.69 | $416.87 |
Where Missouri sits
The same service costs 2.8 times more in Montana 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
$427
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.