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 $77.62 Median $77.62 Typical High $102.33 | Facility | None | $77.62 | $77.62 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $79.43 Typical High $102.33 | Professional | None | $77.62 | $79.43 | $102.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $39.81 Typical High $51.29 | Professional | 52 · Reduced service | $38.02 | $39.81 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.85 Typical High $20.42 | Professional | 53 · Discontinued | $15.49 | $15.85 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.75 Typical High $15.49 | Professional | 55 · Aftercare only | $11.48 | $11.75 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.94 Typical High $10.23 | Professional | 56 · Pre-op care only | $7.76 | $7.94 | $10.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $501.19 | Facility | None | $109.65 | $109.65 | $501.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $93.33 | Professional | None | $52.48 | $52.48 | $93.33 |
BCBS Kansas City Setting Professional Modifier None Typical Low $60.26 Median $66.07 Typical High $66.07 | Professional | None | $60.26 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Medica Setting Facility Modifier None Typical Low $79.43 Median $239.88 Typical High $1,000.00 | Facility | None | $79.43 | $239.88 | $1,000.00 |
Medica Setting Professional Modifier None Typical Low $44.67 Median $53.70 Typical High $707.95 | Professional | None | $44.67 | $53.70 | $707.95 |
United Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
United Setting Professional Modifier None Typical Low $44.67 Median $50.12 Typical High $75.86 | Professional | None | $44.67 | $50.12 | $75.86 |
1 more rate 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 |
|---|---|---|---|---|---|
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $40.74 Median $60.26 Typical High $91.20 | Professional | UE · Used equipment | $40.74 | $60.26 | $91.20 |
Where Missouri sits
The same service costs 3.2 times more in Hawaii than in Arizona. 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
$53.70
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.