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 $24.55 Median $24.55 Typical High $32.36 | Facility | None | $24.55 | $24.55 | $32.36 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $25.12 Typical High $32.36 | Professional | None | $24.55 | $25.12 | $32.36 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.30 Median $12.59 Typical High $16.22 | Professional | 52 · Reduced service | $12.30 | $12.59 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $5.01 Typical High $6.46 | Professional | 53 · Discontinued | $4.90 | $5.01 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $3.80 Typical High $4.90 | Professional | 55 · Aftercare only | $3.63 | $3.80 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.51 Typical High $3.24 | Professional | 56 · Pre-op care only | $2.45 | $2.51 | $3.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $162.18 | Facility | None | $34.67 | $34.67 | $162.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $28.84 | Professional | None | $16.22 | $16.22 | $28.84 |
BCBS Kansas City Setting Professional Modifier None Typical Low $19.05 Median $20.89 Typical High $20.89 | Professional | None | $19.05 | $20.89 | $20.89 |
Cigna Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | None | $16.60 | $16.60 | $16.60 |
Medica Setting Facility Modifier None Typical Low $25.70 Median $45.71 Typical High $199.53 | Facility | None | $25.70 | $45.71 | $199.53 |
Medica Setting Professional Modifier None Typical Low $14.13 Median $16.98 Typical High $389.05 | Professional | None | $14.13 | $16.98 | $389.05 |
United Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
United Setting Professional Modifier None Typical Low $14.13 Median $15.85 Typical High $24.55 | Professional | None | $14.13 | $15.85 | $24.55 |
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 $13.18 Median $19.50 Typical High $29.51 | Professional | UE · Used equipment | $13.18 | $19.50 | $29.51 |
Where Missouri sits
The same service costs 5.9 times more in Hawaii than in Utah. 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· 48th of 51
$16.98
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.