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 $14.45 Median $21.38 Typical High $21.38 | Facility | None | $14.45 | $21.38 | $21.38 |
Aetna Setting Professional Modifier None Typical Low $14.45 Median $21.38 Typical High $30.20 | Professional | None | $14.45 | $21.38 | $30.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $147.91 | Facility | None | $32.36 | $32.36 | $147.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.98 Median $25.12 Typical High $28.18 | Professional | None | $16.98 | $25.12 | $28.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $12.88 Median $16.98 Typical High $22.39 | Professional | UE · Used equipment | $12.88 | $16.98 | $22.39 |
BCBS Kansas City Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $32.36 | Professional | None | $19.50 | $19.50 | $32.36 |
Cigna Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $26.92 | Facility | None | $25.12 | $25.12 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $25.12 | Professional | None | $21.38 | $21.38 | $25.12 |
Medica Setting Facility Modifier None Typical Low $14.45 Median $30.90 Typical High $134.90 | Facility | None | $14.45 | $30.90 | $134.90 |
Medica Setting Professional Modifier None Typical Low $11.75 Median $15.85 Typical High $158.49 | Professional | None | $11.75 | $15.85 | $158.49 |
United Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
United Setting Professional Modifier None Typical Low $10.96 Median $15.85 Typical High $22.39 | Professional | None | $10.96 | $15.85 | $22.39 |
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 $7.24 Median $10.72 Typical High $15.14 | Professional | 52 · Reduced service | $7.24 | $10.72 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.88 Median $4.27 Typical High $6.03 | Professional | 53 · Discontinued | $2.88 | $4.27 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $3.16 Typical High $4.47 | Professional | 55 · Aftercare only | $2.14 | $3.16 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $2.14 Typical High $3.02 | Professional | 56 · Pre-op care only | $1.45 | $2.14 | $3.02 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.24 Median $2.51 Typical High $25.12 | Professional | RR · Rental | $2.24 | $2.51 | $25.12 |
Where Missouri sits
The same service costs 2.1 times more in Minnesota than in Washington, DC. 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
$21.38
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.