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 $4,570.88 Median $6,760.83 Typical High $6,760.83 | Facility | None | $4,570.88 | $6,760.83 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $4,570.88 Median $6,760.83 Typical High $9,549.93 | Professional | None | $4,570.88 | $6,760.83 | $9,549.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,232.93 Median $10,232.93 Typical High $47,863.01 | Facility | None | $10,232.93 | $10,232.93 | $47,863.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $5,623.41 Median $6,606.93 Typical High $8,317.64 | Professional | None | $5,623.41 | $6,606.93 | $8,317.64 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4,265.80 Median $4,897.79 Typical High $7,079.46 | Professional | UE · Used equipment | $4,265.80 | $4,897.79 | $7,079.46 |
BCBS Kansas City Setting Professional Modifier None Typical Low $6,165.95 Median $6,165.95 Typical High $10,232.93 | Professional | None | $6,165.95 | $6,165.95 | $10,232.93 |
Cigna Setting Facility Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $8,317.64 | Facility | None | $7,585.78 | $7,585.78 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $7,585.78 | Professional | None | $5,495.41 | $5,495.41 | $7,585.78 |
Medica Setting Facility Modifier None Typical Low $4,897.79 Median $10,000.00 Typical High $48,977.88 | Facility | None | $4,897.79 | $10,000.00 | $48,977.88 |
Medica Setting Professional Modifier None Typical Low $3,890.45 Median $5,370.32 Typical High $54,954.09 | Professional | None | $3,890.45 | $5,370.32 | $54,954.09 |
United Setting Facility Modifier None Typical Low $4,265.80 Median $4,786.30 Typical High $12,882.50 | Facility | None | $4,265.80 | $4,786.30 | $12,882.50 |
United Setting Professional Modifier None Typical Low $3,715.35 Median $5,011.87 Typical High $7,244.36 | Professional | None | $3,715.35 | $5,011.87 | $7,244.36 |
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 $2,290.87 Median $3,388.44 Typical High $4,786.30 | Professional | 52 · Reduced service | $2,290.87 | $3,388.44 | $4,786.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $933.25 Median $1,380.38 Typical High $1,905.46 | Professional | 53 · Discontinued | $933.25 | $1,380.38 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $691.83 Median $1,023.29 Typical High $1,445.44 | Professional | 55 · Aftercare only | $691.83 | $1,023.29 | $1,445.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $457.09 Median $676.08 Typical High $954.99 | Professional | 56 · Pre-op care only | $457.09 | $676.08 | $954.99 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $660.69 Median $660.69 Typical High $6,606.93 | Professional | RR · Rental | $660.69 | $660.69 | $6,606.93 |
Where Missouri sits
The same service costs 2.1 times more in Montana than in Pennsylvania. 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· 35th of 51
$6,310
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.