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 $54.95 Median $54.95 Typical High $74.13 | Facility | None | $54.95 | $54.95 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $56.23 Typical High $74.13 | Professional | None | $54.95 | $56.23 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $363.08 | Facility | None | $79.43 | $79.43 | $363.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $35.48 Median $44.67 Typical High $57.54 | Professional | None | $35.48 | $44.67 | $57.54 |
BCBS Kansas City Setting Professional Modifier None Typical Low $42.66 Median $46.77 Typical High $46.77 | Professional | None | $42.66 | $46.77 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Medica Setting Facility Modifier None Typical Low $57.54 Median $165.96 Typical High $1,000.00 | Facility | None | $57.54 | $165.96 | $1,000.00 |
Medica Setting Professional Modifier None Typical Low $32.36 Median $38.02 Typical High $467.74 | Professional | None | $32.36 | $38.02 | $467.74 |
United Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
United Setting Professional Modifier None Typical Low $15.14 Median $35.48 Typical High $50.12 | Professional | None | $15.14 | $35.48 | $50.12 |
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 $27.54 Median $28.18 Typical High $36.31 | Professional | 52 · Reduced service | $27.54 | $28.18 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $11.22 Typical High $14.79 | Professional | 53 · Discontinued | $10.96 | $11.22 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.51 Typical High $10.96 | Professional | 55 · Aftercare only | $8.32 | $8.51 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.62 Typical High $7.41 | Professional | 56 · Pre-op care only | $5.50 | $5.62 | $7.41 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $29.51 Median $43.65 Typical High $63.10 | Professional | UE · Used equipment | $29.51 | $43.65 | $63.10 |
Where Missouri sits
The same service costs 2.7 times more in Hawaii than in Utah. 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· 43rd of 51
$44.67
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.