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 $41.69 Median $61.66 Typical High $61.66 | Facility | None | $41.69 | $61.66 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $61.66 Typical High $85.11 | Professional | None | $41.69 | $61.66 | $85.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $426.58 | Facility | None | $91.20 | $91.20 | $426.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $48.98 Median $56.23 Typical High $74.13 | Professional | None | $48.98 | $56.23 | $74.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $36.31 Median $40.74 Typical High $63.10 | Professional | UE · Used equipment | $36.31 | $40.74 | $63.10 |
BCBS Kansas City Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $91.20 | Professional | None | $54.95 | $54.95 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $56.23 | Facility | None | $50.12 | $50.12 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $50.12 | Professional | None | $37.15 | $37.15 | $50.12 |
Medica Setting Facility Modifier None Typical Low $41.69 Median $89.13 Typical High $426.58 | Facility | None | $41.69 | $89.13 | $426.58 |
Medica Setting Professional Modifier None Typical Low $33.88 Median $45.71 Typical High $457.09 | Professional | None | $33.88 | $45.71 | $457.09 |
United Setting Facility Modifier None Typical Low $44.67 Median $109.65 Typical High $109.65 | Facility | None | $44.67 | $109.65 | $109.65 |
United Setting Professional Modifier None Typical Low $31.62 Median $44.67 Typical High $64.57 | Professional | None | $31.62 | $44.67 | $64.57 |
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 $20.42 Median $30.20 Typical High $42.66 | Professional | 52 · Reduced service | $20.42 | $30.20 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $12.30 Typical High $17.38 | Professional | 53 · Discontinued | $8.32 | $12.30 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $9.12 Typical High $12.88 | Professional | 55 · Aftercare only | $6.17 | $9.12 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $6.17 Typical High $8.51 | Professional | 56 · Pre-op care only | $4.17 | $6.17 | $8.51 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.50 Median $5.50 Typical High $54.95 | Professional | RR · Rental | $5.50 | $5.50 | $54.95 |
Where Missouri sits
The same service costs 2.8 times more in Kansas 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· 31st of 51
$54.95
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.