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 $398.11 Median $588.84 Typical High $588.84 | Facility | None | $398.11 | $588.84 | $588.84 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $588.84 Typical High $831.76 | Professional | None | $398.11 | $588.84 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $4,073.80 | Facility | None | $891.25 | $891.25 | $4,073.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $537.03 Typical High $724.44 | Professional | None | $501.19 | $537.03 | $724.44 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $371.54 Median $380.19 Typical High $616.60 | Professional | UE · Used equipment | $371.54 | $380.19 | $616.60 |
BCBS Kansas City Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $891.25 | Professional | None | $537.03 | $537.03 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $776.25 | Facility | None | $691.83 | $691.83 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $691.83 | Professional | None | $512.86 | $512.86 | $691.83 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $870.96 Typical High $4,466.84 | Facility | None | $398.11 | $870.96 | $4,466.84 |
Medica Setting Professional Modifier None Typical Low $346.74 Median $467.74 Typical High $5,495.41 | Professional | None | $346.74 | $467.74 | $5,495.41 |
United Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $1,122.02 | Facility | None | $398.11 | $501.19 | $1,122.02 |
United Setting Professional Modifier None Typical Low $323.59 Median $436.52 Typical High $630.96 | Professional | None | $323.59 | $436.52 | $630.96 |
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 $199.53 Median $295.12 Typical High $416.87 | Professional | 52 · Reduced service | $199.53 | $295.12 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $117.49 Typical High $165.96 | Professional | 53 · Discontinued | $79.43 | $117.49 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $89.13 Typical High $125.89 | Professional | 55 · Aftercare only | $60.26 | $89.13 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $58.88 Typical High $83.18 | Professional | 56 · Pre-op care only | $39.81 | $58.88 | $83.18 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $50.12 Median $50.12 Typical High $501.19 | Professional | RR · Rental | $50.12 | $50.12 | $501.19 |
Where Missouri sits
The same service costs 2.4 times more in Hawaii than in Washington, DC. 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
$537
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.