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 $57.54 Median $85.11 Typical High $85.11 | Facility | None | $57.54 | $85.11 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $85.11 Typical High $120.23 | Professional | None | $57.54 | $85.11 | $120.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $588.84 | Facility | None | $128.82 | $128.82 | $588.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $107.15 Typical High $331.13 | Professional | None | $67.61 | $107.15 | $331.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $51.29 Median $87.10 Typical High $251.19 | Professional | UE · Used equipment | $51.29 | $87.10 | $251.19 |
BCBS Kansas City Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $128.82 | Professional | None | $77.62 | $77.62 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $107.15 | Facility | None | $100.00 | $100.00 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $100.00 | Professional | None | $85.11 | $85.11 | $100.00 |
Medica Setting Facility Modifier None Typical Low $57.54 Median $123.03 Typical High $549.54 | Facility | None | $57.54 | $123.03 | $549.54 |
Medica Setting Professional Modifier None Typical Low $46.77 Median $63.10 Typical High $645.65 | Professional | None | $46.77 | $63.10 | $645.65 |
United Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
United Setting Professional Modifier None Typical Low $44.67 Median $63.10 Typical High $89.13 | Professional | None | $44.67 | $63.10 | $89.13 |
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 $28.84 Median $42.66 Typical High $60.26 | Professional | 52 · Reduced service | $28.84 | $42.66 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $16.98 Typical High $23.99 | Professional | 53 · Discontinued | $11.48 | $16.98 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $12.88 Typical High $18.20 | Professional | 55 · Aftercare only | $8.71 | $12.88 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $8.51 Typical High $12.02 | Professional | 56 · Pre-op care only | $5.75 | $8.51 | $12.02 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $33.11 Median $33.11 Typical High $331.13 | Professional | RR · Rental | $33.11 | $33.11 | $331.13 |
Where Missouri sits
The same service costs 2.4 times more in Indiana than in Kentucky. 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· 35th of 51
$85.11
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.