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 $37.15 Median $37.15 Typical High $48.98 | Facility | None | $37.15 | $37.15 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $38.02 Typical High $48.98 | Professional | None | $37.15 | $38.02 | $48.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $245.47 | Facility | None | $52.48 | $52.48 | $245.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $45.71 | Professional | None | $24.55 | $24.55 | $45.71 |
BCBS Setting Professional Modifier None Typical Low $28.84 Median $31.62 Typical High $31.62 | Professional | None | $28.84 | $31.62 | $31.62 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Medica Setting Facility Modifier None Typical Low $38.90 Median $83.18 Typical High $1,000.00 | Facility | None | $38.90 | $83.18 | $1,000.00 |
Medica Setting Professional Modifier None Typical Low $21.38 Median $25.70 Typical High $331.13 | Professional | None | $21.38 | $25.70 | $331.13 |
United Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
United Setting Professional Modifier None Typical Low $10.96 Median $23.99 Typical High $32.36 | Professional | None | $10.96 | $23.99 | $32.36 |
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 $18.62 Median $19.05 Typical High $24.55 | Professional | 52 · Reduced service | $18.62 | $19.05 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.59 Typical High $10.00 | Professional | 53 · Discontinued | $7.41 | $7.59 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.75 Typical High $7.41 | Professional | 55 · Aftercare only | $5.62 | $5.75 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.80 Typical High $4.90 | Professional | 56 · Pre-op care only | $3.72 | $3.80 | $4.90 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $19.95 Median $29.51 Typical High $44.67 | Professional | UE · Used equipment | $19.95 | $29.51 | $44.67 |
Where Missouri sits
The same service costs 3.0 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· 50th of 51
$25.70
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.