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 $11.75 Median $17.38 Typical High $17.38 | Facility | None | $11.75 | $17.38 | $17.38 |
Aetna Setting Professional Modifier None Typical Low $11.75 Median $17.38 Typical High $23.99 | Professional | None | $11.75 | $17.38 | $23.99 |
Ambetter Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $120.23 | Facility | None | $25.70 | $25.70 | $120.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.79 Median $15.85 Typical High $20.89 | Professional | None | $14.79 | $15.85 | $20.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $10.72 Median $11.48 Typical High $17.78 | Professional | UE · Used equipment | $10.72 | $11.48 | $17.78 |
BCBS Kansas City Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $25.70 | Professional | None | $15.49 | $15.49 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $18.62 | Facility | None | $16.60 | $16.60 | $18.62 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $16.60 | Professional | None | $12.02 | $12.02 | $16.60 |
Medica Setting Facility Modifier None Typical Low $11.75 Median $25.70 Typical High $131.83 | Facility | None | $11.75 | $25.70 | $131.83 |
Medica Setting Professional Modifier None Typical Low $10.23 Median $13.80 Typical High $158.49 | Professional | None | $10.23 | $13.80 | $158.49 |
United Setting Facility Modifier None Typical Low $12.88 Median $16.22 Typical High $33.88 | Facility | None | $12.88 | $16.22 | $33.88 |
United Setting Professional Modifier None Typical Low $9.77 Median $12.59 Typical High $19.05 | Professional | None | $9.77 | $12.59 | $19.05 |
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 $5.75 Median $8.51 Typical High $12.02 | Professional | 52 · Reduced service | $5.75 | $8.51 | $12.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $3.47 Typical High $4.79 | Professional | 53 · Discontinued | $2.29 | $3.47 | $4.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $2.57 Typical High $3.63 | Professional | 55 · Aftercare only | $1.74 | $2.57 | $3.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.15 Median $1.74 Typical High $2.40 | Professional | 56 · Pre-op care only | $1.15 | $1.74 | $2.40 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.55 Median $1.55 Typical High $15.85 | Professional | RR · Rental | $1.55 | $1.55 | $15.85 |
Where Missouri sits
The same service costs 3.0 times more in Hawaii than in Delaware. 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· 36th of 51
$15.85
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.