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 $66.07 Median $66.07 Typical High $89.13 | Facility | None | $66.07 | $66.07 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $69.18 Typical High $89.13 | Professional | None | $66.07 | $69.18 | $89.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $436.52 | Facility | None | $95.50 | $95.50 | $436.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $81.28 | Professional | None | $39.81 | $39.81 | $81.28 |
BCBS Kansas City Setting Professional Modifier None Typical Low $52.48 Median $57.54 Typical High $57.54 | Professional | None | $52.48 | $57.54 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
Medica Setting Facility Modifier None Typical Low $69.18 Median $190.55 Typical High $1,000.00 | Facility | None | $69.18 | $190.55 | $1,000.00 |
Medica Setting Professional Modifier None Typical Low $38.90 Median $46.77 Typical High $524.81 | Professional | None | $38.90 | $46.77 | $524.81 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
United Setting Professional Modifier None Typical Low $15.14 Median $42.66 Typical High $60.26 | Professional | None | $15.14 | $42.66 | $60.26 |
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 $33.11 Median $33.88 Typical High $44.67 | Professional | 52 · Reduced service | $33.11 | $33.88 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.80 Typical High $17.78 | Professional | 53 · Discontinued | $13.49 | $13.80 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.23 Typical High $13.49 | Professional | 55 · Aftercare only | $10.00 | $10.23 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.92 Typical High $8.91 | Professional | 56 · Pre-op care only | $6.61 | $6.92 | $8.91 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $35.48 Median $52.48 Typical High $79.43 | Professional | UE · Used equipment | $35.48 | $52.48 | $79.43 |
Where Missouri sits
The same service costs 2.3 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· 48th of 51
$45.71
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.