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 $50.12 Median $50.12 Typical High $66.07 | Facility | None | $50.12 | $50.12 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $51.29 Typical High $66.07 | Professional | None | $50.12 | $51.29 | $66.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $331.13 | Facility | None | $70.79 | $70.79 | $331.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $61.66 | Professional | None | $28.84 | $28.84 | $61.66 |
BCBS Kansas City Setting Professional Modifier None Typical Low $38.90 Median $42.66 Typical High $42.66 | Professional | None | $38.90 | $42.66 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Medica Setting Facility Modifier None Typical Low $52.48 Median $109.65 Typical High $1,000.00 | Facility | None | $52.48 | $109.65 | $1,000.00 |
Medica Setting Professional Modifier None Typical Low $28.18 Median $34.67 Typical High $426.58 | Professional | None | $28.18 | $34.67 | $426.58 |
United Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
United Setting Professional Modifier None Typical Low $12.88 Median $32.36 Typical High $44.67 | Professional | None | $12.88 | $32.36 | $44.67 |
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 $25.12 Median $25.70 Typical High $33.11 | Professional | 52 · Reduced service | $25.12 | $25.70 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.23 Typical High $13.18 | Professional | 53 · Discontinued | $10.00 | $10.23 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.76 Typical High $10.00 | Professional | 55 · Aftercare only | $7.41 | $7.76 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.13 Typical High $6.61 | Professional | 56 · Pre-op care only | $5.01 | $5.13 | $6.61 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $26.92 Median $39.81 Typical High $60.26 | Professional | UE · Used equipment | $26.92 | $39.81 | $60.26 |
Where Missouri sits
The same service costs 3.0 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· 47th of 51
$33.88
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.