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 $60.26 Median $60.26 Typical High $79.43 | Facility | None | $60.26 | $60.26 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $61.66 Typical High $79.43 | Professional | None | $57.54 | $61.66 | $79.43 |
Anthem BCBS Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $398.11 | Facility | None | $85.11 | $85.11 | $398.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $74.13 | Professional | None | $36.31 | $36.31 | $74.13 |
BCBS Kansas City Setting Professional Modifier None Typical Low $46.77 Median $51.29 Typical High $51.29 | Professional | None | $46.77 | $51.29 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Medica Setting Facility Modifier None Typical Low $61.66 Median $169.82 Typical High $1,000.00 | Facility | None | $61.66 | $169.82 | $1,000.00 |
Medica Setting Professional Modifier None Typical Low $26.30 Median $40.74 Typical High $416.87 | Professional | None | $26.30 | $40.74 | $416.87 |
United Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
United Setting Professional Modifier None Typical Low $15.14 Median $38.90 Typical High $54.95 | Professional | None | $15.14 | $38.90 | $54.95 |
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 $28.84 Median $30.90 Typical High $39.81 | Professional | 52 · Reduced service | $28.84 | $30.90 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $12.30 Typical High $15.85 | Professional | 53 · Discontinued | $11.75 | $12.30 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $9.12 Typical High $12.02 | Professional | 55 · Aftercare only | $8.71 | $9.12 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.17 Typical High $7.94 | Professional | 56 · Pre-op care only | $5.75 | $6.17 | $7.94 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $32.36 Median $46.77 Typical High $64.57 | Professional | UE · Used equipment | $32.36 | $46.77 | $64.57 |
Where Missouri sits
The same service costs 4.2 times more in Minnesota than in Alaska. 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· 37th of 51
$40.74
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.