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 $5.01 Median $7.41 Typical High $7.41 | Facility | None | $5.01 | $7.41 | $7.41 |
Aetna Setting Professional Modifier None Typical Low $5.01 Median $7.41 Typical High $10.47 | Professional | None | $5.01 | $7.41 | $10.47 |
Ambetter Setting Professional Modifier None Typical Low $7.59 Median $8.51 Typical High $8.51 | Professional | None | $7.59 | $8.51 | $8.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $11.22 Median $11.22 Typical High $52.48 | Facility | None | $11.22 | $11.22 | $52.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.46 Median $7.08 Typical High $9.12 | Professional | None | $6.46 | $7.08 | $9.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.68 Median $5.01 Typical High $7.76 | Professional | UE · Used equipment | $4.68 | $5.01 | $7.76 |
BCBS Kansas City Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $11.22 | Professional | None | $6.76 | $6.76 | $11.22 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.94 | Facility | None | $7.08 | $7.08 | $7.94 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $7.08 | Professional | None | $5.25 | $5.25 | $7.08 |
Medica Setting Facility Modifier None Typical Low $5.01 Median $10.96 Typical High $79.43 | Facility | None | $5.01 | $10.96 | $79.43 |
Medica Setting Professional Modifier None Typical Low $4.57 Median $6.03 Typical High $74.13 | Professional | None | $4.57 | $6.03 | $74.13 |
United Setting Facility Modifier None Typical Low $6.31 Median $7.94 Typical High $15.14 | Facility | None | $6.31 | $7.94 | $15.14 |
United Setting Professional Modifier None Typical Low $4.17 Median $5.50 Typical High $8.51 | Professional | None | $4.17 | $5.50 | $8.51 |
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 $2.51 Median $3.72 Typical High $5.25 | Professional | 52 · Reduced service | $2.51 | $3.72 | $5.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.00 Median $1.48 Typical High $2.09 | Professional | 53 · Discontinued | $1.00 | $1.48 | $2.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.76 Median $1.12 Typical High $1.58 | Professional | 55 · Aftercare only | $0.76 | $1.12 | $1.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.51 Median $0.76 Typical High $1.05 | Professional | 56 · Pre-op care only | $0.51 | $0.76 | $1.05 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.68 Median $0.68 Typical High $6.92 | Professional | RR · Rental | $0.68 | $0.68 | $6.92 |
Where Missouri sits
The same service costs 3.5 times more in Montana than in Kansas. 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· 34th of 51
$6.92
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.