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 $134.90 Median $134.90 Typical High $181.97 | Facility | None | $134.90 | $134.90 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $138.04 Typical High $181.97 | Professional | None | $134.90 | $138.04 | $181.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $891.25 | Facility | None | $194.98 | $194.98 | $891.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $154.88 | Professional | None | $75.86 | $75.86 | $154.88 |
BCBS Kansas City Setting Professional Modifier None Typical Low $104.71 Median $117.49 Typical High $117.49 | Professional | None | $104.71 | $117.49 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
Medica Setting Facility Modifier None Typical Low $141.25 Median $426.58 Typical High $1,000.00 | Facility | None | $141.25 | $426.58 | $1,000.00 |
Medica Setting Professional Modifier None Typical Low $72.44 Median $95.50 Typical High $1,778.28 | Professional | None | $72.44 | $95.50 | $1,778.28 |
United Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
United Setting Professional Modifier None Typical Low $15.14 Median $87.10 Typical High $114.82 | Professional | None | $15.14 | $87.10 | $114.82 |
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 $67.61 Median $69.18 Typical High $91.20 | Professional | 52 · Reduced service | $67.61 | $69.18 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $27.54 Typical High $36.31 | Professional | 53 · Discontinued | $26.92 | $27.54 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.89 Typical High $26.92 | Professional | 55 · Aftercare only | $20.42 | $20.89 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.80 Typical High $18.20 | Professional | 56 · Pre-op care only | $13.49 | $13.80 | $18.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $72.44 Median $107.15 Typical High $162.18 | Professional | UE · Used equipment | $72.44 | $107.15 | $162.18 |
Where Missouri sits
The same service costs 5.0 times more in Hawaii than in Florida. 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· 46th of 51
$87.10
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.