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 $208.93 Median $309.03 Typical High $309.03 | Facility | None | $208.93 | $309.03 | $309.03 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $436.52 | Professional | None | $208.93 | $309.03 | $436.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $186.21 Median $281.84 Typical High $426.58 | Professional | None | $186.21 | $281.84 | $426.58 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $141.25 Median $194.98 Typical High $363.08 | Professional | UE · Used equipment | $141.25 | $194.98 | $363.08 |
BCBS Kansas City Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $467.74 | Professional | None | $275.42 | $275.42 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $323.59 | Facility | None | $302.00 | $302.00 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $302.00 | Professional | None | $257.04 | $257.04 | $302.00 |
Medica Setting Facility Modifier None Typical Low $181.97 Median $363.08 Typical High $1,621.81 | Facility | None | $181.97 | $363.08 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $229.09 Typical High $1,995.26 | Professional | None | $151.36 | $229.09 | $1,995.26 |
United Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
United Setting Professional Modifier None Typical Low $141.25 Median $229.09 Typical High $302.00 | Professional | None | $141.25 | $229.09 | $302.00 |
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 $104.71 Median $154.88 Typical High $213.80 | Professional | 52 · Reduced service | $104.71 | $154.88 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $61.66 Typical High $87.10 | Professional | 53 · Discontinued | $41.69 | $61.66 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $45.71 Typical High $64.57 | Professional | 55 · Aftercare only | $30.90 | $45.71 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $30.90 Typical High $43.65 | Professional | 56 · Pre-op care only | $20.89 | $30.90 | $43.65 |
Where Missouri sits
The same service costs 3.0 times more in Iowa 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· 29th 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.