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 $19.05 | Facility | None | $14.13 | $14.13 | $19.05 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $14.45 Typical High $19.05 | Professional | None | $14.13 | $14.45 | $19.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $20.42 Median $20.42 Typical High $93.33 | Facility | None | $20.42 | $20.42 | $93.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.71 Median $11.48 Typical High $14.79 | Professional | None | $8.71 | $11.48 | $14.79 |
BCBS Kansas City Setting Professional Modifier None Typical Low $11.22 Median $12.30 Typical High $12.30 | Professional | None | $11.22 | $12.30 | $12.30 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Medica Setting Facility Modifier None Typical Low $14.79 Median $26.30 Typical High $100.00 | Facility | None | $14.79 | $26.30 | $100.00 |
Medica Setting Professional Modifier None Typical Low $8.32 Median $10.00 Typical High $131.83 | Professional | None | $8.32 | $10.00 | $131.83 |
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 $6.03 Median $9.12 Typical High $14.13 | Professional | None | $6.03 | $9.12 | $14.13 |
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 $9.55 | Professional | 52 · Reduced service | $7.08 | $7.24 | $9.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $2.95 Typical High $3.80 | Professional | 53 · Discontinued | $2.82 | $2.95 | $3.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $2.19 Typical High $2.82 | Professional | 55 · Aftercare only | $2.14 | $2.19 | $2.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $1.45 Typical High $1.91 | Professional | 56 · Pre-op care only | $1.41 | $1.45 | $1.91 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7.59 Median $11.22 Typical High $16.98 | Professional | UE · Used equipment | $7.59 | $11.22 | $16.98 |
Where Missouri sits
The same service costs 3.2 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· 39th of 51
$11.48
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.