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 $190.55 Median $281.84 Typical High $281.84 | Facility | None | $190.55 | $281.84 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $281.84 Typical High $398.11 | Professional | None | $190.55 | $281.84 | $398.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $257.04 Typical High $398.11 | Professional | None | $208.93 | $257.04 | $398.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $158.49 Median $190.55 Typical High $331.13 | Professional | UE · Used equipment | $158.49 | $190.55 | $331.13 |
BCBS Kansas City Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $426.58 | Professional | None | $257.04 | $257.04 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $398.11 | Facility | None | $371.54 | $371.54 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $371.54 | Professional | None | $316.23 | $316.23 | $371.54 |
Medica Setting Facility Modifier None Typical Low $190.55 Median $354.81 Typical High $2,187.76 | Facility | None | $190.55 | $354.81 | $2,187.76 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $229.09 Typical High $2,818.38 | Professional | None | $173.78 | $229.09 | $2,818.38 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
United Setting Professional Modifier None Typical Low $158.49 Median $208.93 Typical High $323.59 | Professional | None | $158.49 | $208.93 | $323.59 |
4 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 $95.50 Median $141.25 Typical High $199.53 | Professional | 52 · Reduced service | $95.50 | $141.25 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $56.23 Typical High $79.43 | Professional | 53 · Discontinued | $38.02 | $56.23 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $42.66 Typical High $60.26 | Professional | 55 · Aftercare only | $28.84 | $42.66 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $28.18 Typical High $39.81 | Professional | 56 · Pre-op care only | $19.05 | $28.18 | $39.81 |
Where Missouri sits
The same service costs 3.4 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· 47th of 51
$257
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.