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 $51.29 Median $75.86 Typical High $75.86 | Facility | None | $51.29 | $75.86 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $75.86 Typical High $107.15 | Professional | None | $51.29 | $75.86 | $107.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $537.03 | Facility | None | $114.82 | $114.82 | $537.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $61.66 Typical High $107.15 | Professional | None | $60.26 | $61.66 | $107.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $45.71 Median $45.71 Typical High $79.43 | Professional | UE · Used equipment | $45.71 | $45.71 | $79.43 |
BCBS Kansas City Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $114.82 | Professional | None | $69.18 | $69.18 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $97.72 | Facility | None | $91.20 | $91.20 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $91.20 | Professional | None | $77.62 | $77.62 | $91.20 |
Medica Setting Facility Modifier None Typical Low $51.29 Median $112.20 Typical High $537.03 | Facility | None | $51.29 | $112.20 | $537.03 |
Medica Setting Professional Modifier None Typical Low $42.66 Median $57.54 Typical High $575.44 | Professional | None | $42.66 | $57.54 | $575.44 |
United Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
United Setting Professional Modifier None Typical Low $39.81 Median $56.23 Typical High $79.43 | Professional | None | $39.81 | $56.23 | $79.43 |
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 $25.70 Median $38.02 Typical High $53.70 | Professional | 52 · Reduced service | $25.70 | $38.02 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $15.14 Typical High $21.38 | Professional | 53 · Discontinued | $10.23 | $15.14 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $11.48 Typical High $16.22 | Professional | 55 · Aftercare only | $7.76 | $11.48 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $7.59 Typical High $10.72 | Professional | 56 · Pre-op care only | $5.13 | $7.59 | $10.72 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.17 Median $6.17 Typical High $61.66 | Professional | RR · Rental | $6.17 | $6.17 | $61.66 |
Where Missouri sits
The same service costs 1.9 times more in Montana than in Virginia. 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· 42nd of 51
$67.61
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.