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 $69.18 Median $69.18 Typical High $91.20 | Facility | None | $69.18 | $69.18 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $70.79 Typical High $91.20 | Professional | None | $69.18 | $70.79 | $91.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $457.09 | Facility | None | $97.72 | $97.72 | $457.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $85.11 | Professional | None | $41.69 | $41.69 | $85.11 |
BCBS Kansas City Setting Professional Modifier None Typical Low $53.70 Median $58.88 Typical High $58.88 | Professional | None | $53.70 | $58.88 | $58.88 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $194.98 Typical High $1,000.00 | Facility | None | $70.79 | $194.98 | $1,000.00 |
Medica Setting Professional Modifier None Typical Low $39.81 Median $47.86 Typical High $630.96 | Professional | None | $39.81 | $47.86 | $630.96 |
United Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
United Setting Professional Modifier None Typical Low $15.14 Median $44.67 Typical High $61.66 | Professional | None | $15.14 | $44.67 | $61.66 |
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 $34.67 Median $35.48 Typical High $45.71 | Professional | 52 · Reduced service | $34.67 | $35.48 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $14.13 Typical High $18.20 | Professional | 53 · Discontinued | $13.80 | $14.13 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.47 Typical High $13.80 | Professional | 55 · Aftercare only | $10.23 | $10.47 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.08 Typical High $9.12 | Professional | 56 · Pre-op care only | $6.92 | $7.08 | $9.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $37.15 Median $53.70 Typical High $83.18 | Professional | UE · Used equipment | $37.15 | $53.70 | $83.18 |
Where Missouri sits
The same service costs 2.5 times more in Montana than in Missouri. 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· 51st of 51
$46.77
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.