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 $61.66 Median $61.66 Typical High $81.28 | Facility | None | $61.66 | $61.66 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $63.10 Typical High $81.28 | Professional | None | $61.66 | $63.10 | $81.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $398.11 | Facility | None | $87.10 | $87.10 | $398.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $74.13 | Professional | None | $38.90 | $38.90 | $74.13 |
BCBS Kansas City Setting Professional Modifier None Typical Low $47.86 Median $52.48 Typical High $52.48 | Professional | None | $47.86 | $52.48 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Medica Setting Facility Modifier None Typical Low $63.10 Median $138.04 Typical High $1,000.00 | Facility | None | $63.10 | $138.04 | $1,000.00 |
Medica Setting Professional Modifier None Typical Low $35.48 Median $42.66 Typical High $467.74 | Professional | None | $35.48 | $42.66 | $467.74 |
United Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
United Setting Professional Modifier None Typical Low $12.88 Median $39.81 Typical High $52.48 | Professional | None | $12.88 | $39.81 | $52.48 |
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 $30.20 Median $31.62 Typical High $40.74 | Professional | 52 · Reduced service | $30.20 | $31.62 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $12.59 Typical High $16.22 | Professional | 53 · Discontinued | $12.30 | $12.59 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.33 Typical High $12.30 | Professional | 55 · Aftercare only | $9.12 | $9.33 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.31 Typical High $8.13 | Professional | 56 · Pre-op care only | $6.17 | $6.31 | $8.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $37.15 Median $38.90 Typical High $54.95 | Professional | UE · Used equipment | $37.15 | $38.90 | $54.95 |
Where Missouri sits
The same service costs 2.4 times more in Hawaii 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
$41.69
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.