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 $302.00 Median $446.68 Typical High $446.68 | Facility | None | $302.00 | $446.68 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $446.68 Typical High $630.96 | Professional | None | $302.00 | $446.68 | $630.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $346.74 Typical High $630.96 | Professional | None | $245.47 | $346.74 | $630.96 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $251.19 Median $281.84 Typical High $524.81 | Professional | UE · Used equipment | $251.19 | $281.84 | $524.81 |
BCBS Kansas City Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $676.08 | Professional | None | $407.38 | $407.38 | $676.08 |
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 $302.00 Median $562.34 Typical High $2,884.03 | Facility | None | $302.00 | $562.34 | $2,884.03 |
Medica Setting Professional Modifier None Typical Low $251.19 Median $338.84 Typical High $3,311.31 | Professional | None | $251.19 | $338.84 | $3,311.31 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $234.42 Median $331.13 Typical High $478.63 | Professional | None | $234.42 | $331.13 | $478.63 |
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 $151.36 Median $223.87 Typical High $316.23 | Professional | 52 · Reduced service | $151.36 | $223.87 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $91.20 Typical High $125.89 | Professional | 53 · Discontinued | $61.66 | $91.20 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $67.61 Typical High $95.50 | Professional | 55 · Aftercare only | $45.71 | $67.61 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $44.67 Typical High $63.10 | Professional | 56 · Pre-op care only | $30.20 | $44.67 | $63.10 |
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· 38th of 51
$339
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.