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 $100.00 Median $100.00 Typical High $134.90 | Facility | None | $100.00 | $100.00 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $102.33 Typical High $134.90 | Professional | None | $100.00 | $102.33 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $660.69 | Facility | None | $144.54 | $144.54 | $660.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $120.23 | Professional | None | $60.26 | $60.26 | $120.23 |
BCBS Kansas City Setting Professional Modifier None Typical Low $85.11 Median $87.10 Typical High $87.10 | Professional | None | $85.11 | $87.10 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $288.40 Typical High $1,000.00 | Facility | None | $104.71 | $288.40 | $1,000.00 |
Medica Setting Professional Modifier None Typical Low $58.88 Median $70.79 Typical High $851.14 | Professional | None | $58.88 | $70.79 | $851.14 |
United Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
United Setting Professional Modifier None Typical Low $15.14 Median $64.57 Typical High $85.11 | Professional | None | $15.14 | $64.57 | $85.11 |
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 $50.12 Median $51.29 Typical High $67.61 | Professional | 52 · Reduced service | $50.12 | $51.29 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $20.89 Typical High $26.92 | Professional | 53 · Discontinued | $19.95 | $20.89 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.49 Typical High $19.95 | Professional | 55 · Aftercare only | $15.14 | $15.49 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.23 Typical High $13.49 | Professional | 56 · Pre-op care only | $10.00 | $10.23 | $13.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $53.70 Median $79.43 Typical High $120.23 | Professional | UE · Used equipment | $53.70 | $79.43 | $120.23 |
Where Missouri sits
The same service costs 3.0 times more in Hawaii than in Indiana. 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
$69.18
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.