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 $63.10 Median $63.10 Typical High $83.18 | Facility | None | $63.10 | $63.10 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $64.57 Typical High $83.18 | Professional | None | $63.10 | $64.57 | $83.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $416.87 | Facility | None | $89.13 | $89.13 | $416.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $77.62 | Professional | None | $48.98 | $48.98 | $77.62 |
BCBS Kansas City Setting Professional Modifier None Typical Low $48.98 Median $53.70 Typical High $53.70 | Professional | None | $48.98 | $53.70 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Medica Setting Facility Modifier None Typical Low $66.07 Median $141.25 Typical High $1,000.00 | Facility | None | $66.07 | $141.25 | $1,000.00 |
Medica Setting Professional Modifier None Typical Low $36.31 Median $43.65 Typical High $562.34 | Professional | None | $36.31 | $43.65 | $562.34 |
United Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
United Setting Professional Modifier None Typical Low $10.96 Median $40.74 Typical High $53.70 | Professional | None | $10.96 | $40.74 | $53.70 |
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 $31.62 Median $32.36 Typical High $41.69 | Professional | 52 · Reduced service | $31.62 | $32.36 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $12.88 Typical High $16.60 | Professional | 53 · Discontinued | $12.59 | $12.88 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.77 Typical High $12.59 | Professional | 55 · Aftercare only | $9.33 | $9.77 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.46 Typical High $8.32 | Professional | 56 · Pre-op care only | $6.31 | $6.46 | $8.32 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $38.02 Median $48.98 Typical High $75.86 | Professional | UE · Used equipment | $38.02 | $48.98 | $75.86 |
Where Missouri sits
The same service costs 3.2 times more in Hawaii 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· 44th of 51
$48.98
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.