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 $14.13 Median $14.13 Typical High $18.62 | Facility | None | $14.13 | $14.13 | $18.62 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $14.45 Typical High $18.62 | Professional | None | $14.13 | $14.45 | $18.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $93.33 | Facility | None | $19.95 | $19.95 | $93.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $17.38 | Professional | None | $9.12 | $9.12 | $17.38 |
BCBS Kansas City Setting Professional Modifier None Typical Low $10.96 Median $12.02 Typical High $12.02 | Professional | None | $10.96 | $12.02 | $12.02 |
Cigna Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
Medica Setting Facility Modifier None Typical Low $14.45 Median $26.30 Typical High $100.00 | Facility | None | $14.45 | $26.30 | $100.00 |
Medica Setting Professional Modifier None Typical Low $8.13 Median $9.77 Typical High $123.03 | Professional | None | $8.13 | $9.77 | $123.03 |
United Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
United Setting Professional Modifier None Typical Low $8.13 Median $9.77 Typical High $19.95 | Professional | None | $8.13 | $9.77 | $19.95 |
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 $7.08 Median $7.24 Typical High $9.33 | Professional | 52 · Reduced service | $7.08 | $7.24 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $2.88 Typical High $3.72 | Professional | 53 · Discontinued | $2.82 | $2.88 | $3.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.09 Median $2.14 Typical High $2.82 | Professional | 55 · Aftercare only | $2.09 | $2.14 | $2.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $1.45 Typical High $1.86 | Professional | 56 · Pre-op care only | $1.41 | $1.45 | $1.86 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $8.51 Median $11.22 Typical High $16.98 | Professional | UE · Used equipment | $8.51 | $11.22 | $16.98 |
Where Missouri sits
The same service costs 3.0 times more in Montana than in New York. 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· 46th of 51
$9.77
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.