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 $50.12 Median $50.12 Typical High $66.07 | Facility | None | $50.12 | $50.12 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $51.29 Typical High $66.07 | Professional | None | $50.12 | $51.29 | $66.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $331.13 | Facility | None | $70.79 | $70.79 | $331.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $61.66 | Professional | None | $39.81 | $39.81 | $61.66 |
BCBS Kansas City Setting Professional Modifier None Typical Low $38.90 Median $42.66 Typical High $42.66 | Professional | None | $38.90 | $42.66 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Medica Setting Facility Modifier None Typical Low $51.29 Median $112.20 Typical High $1,000.00 | Facility | None | $51.29 | $112.20 | $1,000.00 |
Medica Setting Professional Modifier None Typical Low $28.84 Median $34.67 Typical High $467.74 | Professional | None | $28.84 | $34.67 | $467.74 |
United Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
United Setting Professional Modifier None Typical Low $10.96 Median $32.36 Typical High $42.66 | Professional | None | $10.96 | $32.36 | $42.66 |
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 $25.12 Median $25.70 Typical High $33.11 | Professional | 52 · Reduced service | $25.12 | $25.70 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.23 Typical High $13.18 | Professional | 53 · Discontinued | $10.00 | $10.23 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.59 Typical High $10.00 | Professional | 55 · Aftercare only | $7.41 | $7.59 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.13 Typical High $6.61 | Professional | 56 · Pre-op care only | $5.01 | $5.13 | $6.61 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $30.20 Median $38.90 Typical High $60.26 | Professional | UE · Used equipment | $30.20 | $38.90 | $60.26 |
Where Missouri sits
The same service costs 3.1 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· 42nd of 51
$39.81
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.