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 $41.69 Median $41.69 Typical High $56.23 | Facility | None | $41.69 | $41.69 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $42.66 Typical High $56.23 | Professional | None | $41.69 | $42.66 | $56.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $275.42 | Facility | None | $60.26 | $60.26 | $275.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $51.29 | Professional | None | $27.54 | $27.54 | $51.29 |
BCBS Kansas City Setting Professional Modifier None Typical Low $32.36 Median $36.31 Typical High $36.31 | Professional | None | $32.36 | $36.31 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Medica Setting Facility Modifier None Typical Low $43.65 Median $93.33 Typical High $1,000.00 | Facility | None | $43.65 | $93.33 | $1,000.00 |
Medica Setting Professional Modifier None Typical Low $24.55 Median $29.51 Typical High $371.54 | Professional | None | $24.55 | $29.51 | $371.54 |
United Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
United Setting Professional Modifier None Typical Low $10.96 Median $26.92 Typical High $35.48 | Professional | None | $10.96 | $26.92 | $35.48 |
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 $20.89 Median $21.38 Typical High $28.18 | Professional | 52 · Reduced service | $20.89 | $21.38 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.71 Typical High $11.22 | Professional | 53 · Discontinued | $8.32 | $8.71 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.46 Typical High $8.32 | Professional | 55 · Aftercare only | $6.31 | $6.46 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.27 Typical High $5.62 | Professional | 56 · Pre-op care only | $4.17 | $4.27 | $5.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $22.39 Median $33.11 Typical High $50.12 | Professional | UE · Used equipment | $22.39 | $33.11 | $50.12 |
Where Missouri sits
The same service costs 2.6 times more in Montana than in Indiana. 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· 49th of 51
$28.84
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.