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 $85.11 Median $85.11 Typical High $114.82 | Facility | None | $85.11 | $85.11 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $87.10 Typical High $114.82 | Professional | None | $85.11 | $87.10 | $114.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $562.34 | Facility | None | $123.03 | $123.03 | $562.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $104.71 | Professional | None | $53.70 | $53.70 | $104.71 |
BCBS Kansas City Setting Professional Modifier None Typical Low $67.61 Median $74.13 Typical High $74.13 | Professional | None | $67.61 | $74.13 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Medica Setting Facility Modifier None Typical Low $89.13 Median $269.15 Typical High $1,000.00 | Facility | None | $89.13 | $269.15 | $1,000.00 |
Medica Setting Professional Modifier None Typical Low $50.12 Median $60.26 Typical High $851.14 | Professional | None | $50.12 | $60.26 | $851.14 |
United Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
United Setting Professional Modifier None Typical Low $15.14 Median $54.95 Typical High $72.44 | Professional | None | $15.14 | $54.95 | $72.44 |
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 $42.66 Median $43.65 Typical High $57.54 | Professional | 52 · Reduced service | $42.66 | $43.65 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $17.78 Typical High $22.91 | Professional | 53 · Discontinued | $16.98 | $17.78 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $13.18 Typical High $16.98 | Professional | 55 · Aftercare only | $12.88 | $13.18 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.71 Typical High $11.48 | Professional | 56 · Pre-op care only | $8.51 | $8.71 | $11.48 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $45.71 Median $67.61 Typical High $102.33 | Professional | UE · Used equipment | $45.71 | $67.61 | $102.33 |
Where Missouri sits
The same service costs 4.0 times more in Hawaii than in New York. 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
$58.88
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.