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 $74.13 Median $74.13 Typical High $97.72 | Facility | None | $74.13 | $74.13 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $75.86 Typical High $97.72 | Professional | None | $74.13 | $75.86 | $97.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $489.78 | Facility | None | $104.71 | $104.71 | $489.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $91.20 | Professional | None | $43.65 | $43.65 | $91.20 |
BCBS Kansas City Setting Professional Modifier None Typical Low $57.54 Median $63.10 Typical High $63.10 | Professional | None | $57.54 | $63.10 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Medica Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,000.00 | Facility | None | $77.62 | $165.96 | $1,000.00 |
Medica Setting Professional Modifier None Typical Low $41.69 Median $51.29 Typical High $616.60 | Professional | None | $41.69 | $51.29 | $616.60 |
United Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
United Setting Professional Modifier None Typical Low $12.88 Median $47.86 Typical High $63.10 | Professional | None | $12.88 | $47.86 | $63.10 |
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 $37.15 Median $38.02 Typical High $48.98 | Professional | 52 · Reduced service | $37.15 | $38.02 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $15.14 Typical High $19.50 | Professional | 53 · Discontinued | $14.79 | $15.14 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $11.48 Typical High $14.79 | Professional | 55 · Aftercare only | $10.96 | $11.48 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.59 Typical High $9.77 | Professional | 56 · Pre-op care only | $7.41 | $7.59 | $9.77 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $39.81 Median $58.88 Typical High $83.18 | Professional | UE · Used equipment | $39.81 | $58.88 | $83.18 |
Where Missouri sits
The same service costs 2.6 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· 47th of 51
$50.12
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.