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 $9.55 Median $9.55 Typical High $12.59 | Facility | None | $9.55 | $9.55 | $12.59 |
Aetna Setting Professional Modifier None Typical Low $9.55 Median $9.77 Typical High $12.59 | Professional | None | $9.55 | $9.77 | $12.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $63.10 | Facility | None | $13.49 | $13.49 | $63.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $11.75 | Professional | None | $5.25 | $5.25 | $11.75 |
BCBS Kansas City Setting Professional Modifier None Typical Low $7.94 Median $8.13 Typical High $8.13 | Professional | None | $7.94 | $8.13 | $8.13 |
Cigna Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | None | $6.03 | $6.03 | $6.03 |
Medica Setting Facility Modifier None Typical Low $9.77 Median $17.38 Typical High $100.00 | Facility | None | $9.77 | $17.38 | $100.00 |
Medica Setting Professional Modifier None Typical Low $5.13 Median $6.61 Typical High $81.28 | Professional | None | $5.13 | $6.61 | $81.28 |
United Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
United Setting Professional Modifier None Typical Low $3.98 Median $6.17 Typical High $10.23 | Professional | None | $3.98 | $6.17 | $10.23 |
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 $4.79 Median $4.90 Typical High $6.31 | Professional | 52 · Reduced service | $4.79 | $4.90 | $6.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.91 Median $1.95 Typical High $2.51 | Professional | 53 · Discontinued | $1.91 | $1.95 | $2.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.45 Median $1.45 Typical High $1.91 | Professional | 55 · Aftercare only | $1.45 | $1.45 | $1.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $0.98 Typical High $1.26 | Professional | 56 · Pre-op care only | $0.95 | $0.98 | $1.26 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5.62 Median $7.59 Typical High $11.48 | Professional | UE · Used equipment | $5.62 | $7.59 | $11.48 |
Where Missouri sits
The same service costs 2.7 times more in Montana 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· 45th of 51
$6.46
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.