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 $91.20 Median $91.20 Typical High $123.03 | Facility | None | $91.20 | $91.20 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $95.50 Typical High $123.03 | Professional | None | $91.20 | $95.50 | $123.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $602.56 | Facility | None | $131.83 | $131.83 | $602.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $112.20 | Professional | None | $54.95 | $54.95 | $112.20 |
BCBS Kansas City Setting Professional Modifier None Typical Low $72.44 Median $79.43 Typical High $79.43 | Professional | None | $72.44 | $79.43 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Medica Setting Facility Modifier None Typical Low $95.50 Median $263.03 Typical High $1,000.00 | Facility | None | $95.50 | $263.03 | $1,000.00 |
Medica Setting Professional Modifier None Typical Low $53.70 Median $64.57 Typical High $707.95 | Professional | None | $53.70 | $64.57 | $707.95 |
United Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
United Setting Professional Modifier None Typical Low $15.14 Median $58.88 Typical High $79.43 | Professional | None | $15.14 | $58.88 | $79.43 |
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 $45.71 Median $46.77 Typical High $61.66 | Professional | 52 · Reduced service | $45.71 | $46.77 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $19.05 Typical High $24.55 | Professional | 53 · Discontinued | $18.62 | $19.05 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $14.13 Typical High $18.62 | Professional | 55 · Aftercare only | $13.80 | $14.13 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.33 Typical High $12.30 | Professional | 56 · Pre-op care only | $9.12 | $9.33 | $12.30 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $48.98 Median $72.44 Typical High $109.65 | Professional | UE · Used equipment | $48.98 | $72.44 | $109.65 |
Where Missouri sits
The same service costs 2.9 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· 48th of 51
$63.10
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.