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 $38.90 Median $38.90 Typical High $52.48 | Facility | None | $38.90 | $38.90 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $39.81 Typical High $52.48 | Professional | None | $38.90 | $39.81 | $52.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $257.04 | Facility | None | $56.23 | $56.23 | $257.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $47.86 | Professional | None | $27.54 | $27.54 | $47.86 |
BCBS Kansas City Setting Professional Modifier None Typical Low $30.20 Median $33.11 Typical High $33.11 | Professional | None | $30.20 | $33.11 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
Medica Setting Facility Modifier None Typical Low $40.74 Median $87.10 Typical High $1,000.00 | Facility | None | $40.74 | $87.10 | $1,000.00 |
Medica Setting Professional Modifier None Typical Low $22.91 Median $27.54 Typical High $346.74 | Professional | None | $22.91 | $27.54 | $346.74 |
United Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
United Setting Professional Modifier None Typical Low $10.96 Median $25.12 Typical High $33.11 | Professional | None | $10.96 | $25.12 | $33.11 |
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 $19.50 Median $19.95 Typical High $25.70 | Professional | 52 · Reduced service | $19.50 | $19.95 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $7.94 Typical High $10.47 | Professional | 53 · Discontinued | $7.76 | $7.94 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $6.03 Typical High $7.76 | Professional | 55 · Aftercare only | $5.89 | $6.03 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $3.98 Typical High $5.25 | Professional | 56 · Pre-op care only | $3.89 | $3.98 | $5.25 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $21.38 Median $30.90 Typical High $44.67 | Professional | UE · Used equipment | $21.38 | $30.90 | $44.67 |
Where Missouri sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 46th of 51
$27.54
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.