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 $39.81 Median $58.88 Typical High $58.88 | Facility | None | $39.81 | $58.88 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $58.88 Typical High $83.18 | Professional | None | $39.81 | $58.88 | $83.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $407.38 | Facility | None | $89.13 | $89.13 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $48.98 Typical High $81.28 | Professional | None | $46.77 | $48.98 | $81.28 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $35.48 Median $35.48 Typical High $60.26 | Professional | UE · Used equipment | $35.48 | $35.48 | $60.26 |
BCBS Kansas City Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $89.13 | Professional | None | $53.70 | $53.70 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $74.13 | Facility | None | $69.18 | $69.18 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $69.18 | Professional | None | $58.88 | $58.88 | $69.18 |
Medica Setting Facility Modifier None Typical Low $39.81 Median $85.11 Typical High $407.38 | Facility | None | $39.81 | $85.11 | $407.38 |
Medica Setting Professional Modifier None Typical Low $32.36 Median $43.65 Typical High $446.68 | Professional | None | $32.36 | $43.65 | $446.68 |
United Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
United Setting Professional Modifier None Typical Low $30.90 Median $43.65 Typical High $61.66 | Professional | None | $30.90 | $43.65 | $61.66 |
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 $19.95 Median $29.51 Typical High $41.69 | Professional | 52 · Reduced service | $19.95 | $29.51 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $11.75 Typical High $16.60 | Professional | 53 · Discontinued | $7.94 | $11.75 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $8.91 Typical High $12.59 | Professional | 55 · Aftercare only | $6.03 | $8.91 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $5.89 Typical High $8.32 | Professional | 56 · Pre-op care only | $3.98 | $5.89 | $8.32 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.79 Median $4.79 Typical High $48.98 | Professional | RR · Rental | $4.79 | $4.79 | $48.98 |
Where Missouri sits
The same service costs 2.0 times more in Montana than in South Carolina. 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· 43rd of 51
$51.29
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.