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 $19,952.62 Median $29,512.09 Typical High $29,512.09 | Facility | None | $19,952.62 | $29,512.09 | $29,512.09 |
Aetna Setting Professional Modifier None Typical Low $19,952.62 Median $29,512.09 Typical High $41,686.94 | Professional | None | $19,952.62 | $29,512.09 | $41,686.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $44,668.36 Median $44,668.36 Typical High $204,173.79 | Facility | None | $44,668.36 | $44,668.36 | $204,173.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $23,442.29 Median $26,915.35 Typical High $35,481.34 | Professional | None | $23,442.29 | $26,915.35 | $35,481.34 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $17,782.79 Median $17,782.79 Typical High $30,902.95 | Professional | UE · Used equipment | $17,782.79 | $17,782.79 | $30,902.95 |
BCBS Kansas City Setting Professional Modifier None Typical Low $26,302.68 Median $26,302.68 Typical High $44,668.36 | Professional | None | $26,302.68 | $26,302.68 | $44,668.36 |
Cigna Setting Facility Modifier None Typical Low $30,199.52 Median $30,199.52 Typical High $33,884.42 | Facility | None | $30,199.52 | $30,199.52 | $33,884.42 |
Cigna Setting Professional Modifier None Typical Low $22,387.21 Median $22,387.21 Typical High $30,199.52 | Professional | None | $22,387.21 | $22,387.21 | $30,199.52 |
Medica Setting Facility Modifier None Typical Low $19,952.62 Median $42,657.95 Typical High $204,173.79 | Facility | None | $19,952.62 | $42,657.95 | $204,173.79 |
Medica Setting Professional Modifier None Typical Low $16,218.10 Median $22,387.21 Typical High $245,470.89 | Professional | None | $16,218.10 | $22,387.21 | $245,470.89 |
United Setting Facility Modifier None Typical Low $53,703.18 Median $53,703.18 Typical High $53,703.18 | Facility | None | $53,703.18 | $53,703.18 | $53,703.18 |
United Setting Professional Modifier None Typical Low $15,488.17 Median $21,877.62 Typical High $30,902.95 | Professional | None | $15,488.17 | $21,877.62 | $30,902.95 |
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 $10,000.00 Median $14,791.08 Typical High $20,417.38 | Professional | 52 · Reduced service | $10,000.00 | $14,791.08 | $20,417.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3,981.07 Median $5,888.44 Typical High $8,317.64 | Professional | 53 · Discontinued | $3,981.07 | $5,888.44 | $8,317.64 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2,951.21 Median $4,365.16 Typical High $6,165.95 | Professional | 55 · Aftercare only | $2,951.21 | $4,365.16 | $6,165.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1,995.26 Median $2,951.21 Typical High $4,168.69 | Professional | 56 · Pre-op care only | $1,995.26 | $2,951.21 | $4,168.69 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2,398.83 Median $2,398.83 Typical High $23,988.33 | Professional | RR · Rental | $2,398.83 | $2,398.83 | $23,988.33 |
Where Missouri sits
The same service costs 2.1 times more in Hawaii than in New Jersey. 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· 32nd of 51
$25,119
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.