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 $64.57 Median $64.57 Typical High $87.10 | Facility | None | $64.57 | $64.57 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $66.07 Typical High $87.10 | Professional | None | $64.57 | $66.07 | $87.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $33.11 Typical High $43.65 | Professional | 52 · Reduced service | $32.36 | $33.11 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $13.18 Typical High $17.38 | Professional | 53 · Discontinued | $12.88 | $13.18 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $10.00 Typical High $12.88 | Professional | 55 · Aftercare only | $9.55 | $10.00 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.61 Typical High $8.71 | Professional | 56 · Pre-op care only | $6.46 | $6.61 | $8.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $426.58 | Facility | None | $93.33 | $93.33 | $426.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $79.43 | Professional | None | $38.02 | $38.02 | $79.43 |
BCBS Kansas City Setting Professional Modifier None Typical Low $50.12 Median $56.23 Typical High $56.23 | Professional | None | $50.12 | $56.23 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Medica Setting Facility Modifier None Typical Low $67.61 Median $117.49 Typical High $416.87 | Facility | None | $67.61 | $117.49 | $416.87 |
Medica Setting Professional Modifier None Typical Low $32.36 Median $44.67 Typical High $489.78 | Professional | None | $32.36 | $44.67 | $489.78 |
United Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
United Setting Professional Modifier None Typical Low $32.36 Median $41.69 Typical High $64.57 | Professional | None | $32.36 | $41.69 | $64.57 |
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 $34.67 Median $51.29 Typical High $77.62 | Professional | UE · Used equipment | $34.67 | $51.29 | $77.62 |
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· 45th of 51
$43.65
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.