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 $120.23 Median $138.04 Typical High $489.78 | Facility | None | $120.23 | $138.04 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $177.83 Typical High $251.19 | Professional | None | $120.23 | $177.83 | $251.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $165.96 Typical High $245.47 | Professional | None | $123.03 | $165.96 | $245.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $93.33 Median $112.20 Typical High $208.93 | Professional | UE · Used equipment | $93.33 | $112.20 | $208.93 |
BCBS Kansas City Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $269.15 | Professional | None | $162.18 | $162.18 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $208.93 | Facility | None | $194.98 | $194.98 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $194.98 | Professional | None | $165.96 | $165.96 | $194.98 |
Medica Setting Facility Modifier None Typical Low $120.23 Median $251.19 Typical High $1,148.15 | Facility | None | $120.23 | $251.19 | $1,148.15 |
Medica Setting Professional Modifier None Typical Low $97.72 Median $134.90 Typical High $1,318.26 | Professional | None | $97.72 | $134.90 | $1,318.26 |
United Setting Professional Modifier None Typical Low $93.33 Median $131.83 Typical High $186.21 | Professional | None | $93.33 | $131.83 | $186.21 |
2 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 55 · Aftercare only Typical Low $18.20 Median $26.92 Typical High $38.02 | Professional | 55 · Aftercare only | $18.20 | $26.92 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $17.78 Typical High $25.12 | Professional | 56 · Pre-op care only | $12.02 | $17.78 | $25.12 |
Where Missouri sits
The same service costs 2.6 times more in Montana than in New York. 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
$166
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.