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 $45.71 Median $45.71 Typical High $60.26 | Facility | None | $45.71 | $45.71 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $46.77 Typical High $60.26 | Professional | None | $45.71 | $46.77 | $60.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $302.00 | Facility | None | $64.57 | $64.57 | $302.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $56.23 | Professional | None | $26.92 | $26.92 | $56.23 |
BCBS Kansas City Setting Professional Modifier None Typical Low $35.48 Median $38.90 Typical High $38.90 | Professional | None | $35.48 | $38.90 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Medica Setting Facility Modifier None Typical Low $46.77 Median $100.00 Typical High $1,000.00 | Facility | None | $46.77 | $100.00 | $1,000.00 |
Medica Setting Professional Modifier None Typical Low $25.70 Median $31.62 Typical High $398.11 | Professional | None | $25.70 | $31.62 | $398.11 |
United Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
United Setting Professional Modifier None Typical Low $12.88 Median $29.51 Typical High $40.74 | Professional | None | $12.88 | $29.51 | $40.74 |
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 $22.91 Median $23.44 Typical High $30.20 | Professional | 52 · Reduced service | $22.91 | $23.44 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.33 Typical High $12.02 | Professional | 53 · Discontinued | $9.12 | $9.33 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $6.92 Typical High $9.12 | Professional | 55 · Aftercare only | $6.76 | $6.92 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.68 Typical High $6.03 | Professional | 56 · Pre-op care only | $4.57 | $4.68 | $6.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $27.54 Median $36.31 Typical High $54.95 | Professional | UE · Used equipment | $27.54 | $36.31 | $54.95 |
Where Missouri sits
The same service costs 2.8 times more in Montana than in Ohio. 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· 48th of 51
$30.90
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.