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 $13.80 Median $13.80 Typical High $18.20 | Facility | None | $13.80 | $13.80 | $18.20 |
Aetna Setting Professional Modifier None Typical Low $13.80 Median $14.13 Typical High $18.20 | Professional | None | $13.80 | $14.13 | $18.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $91.20 | Facility | None | $19.50 | $19.50 | $91.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.51 Median $11.22 Typical High $14.45 | Professional | None | $8.51 | $11.22 | $14.45 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $8.32 Median $8.51 Typical High $10.96 | Professional | UE · Used equipment | $8.32 | $8.51 | $10.96 |
BCBS Kansas City Setting Professional Modifier None Typical Low $10.72 Median $11.75 Typical High $11.75 | Professional | None | $10.72 | $11.75 | $11.75 |
Cigna Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
Medica Setting Facility Modifier None Typical Low $14.13 Median $25.12 Typical High $102.33 | Facility | None | $14.13 | $25.12 | $102.33 |
Medica Setting Professional Modifier None Typical Low $7.94 Median $9.55 Typical High $147.91 | Professional | None | $7.94 | $9.55 | $147.91 |
United Setting Professional Modifier None Typical Low $7.94 Median $8.91 Typical High $13.80 | Professional | None | $7.94 | $8.91 | $13.80 |
4 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 $6.92 Median $7.08 Typical High $9.12 | Professional | 52 · Reduced service | $6.92 | $7.08 | $9.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.75 Median $2.82 Typical High $3.63 | Professional | 53 · Discontinued | $2.75 | $2.82 | $3.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.04 Median $2.09 Typical High $2.75 | Professional | 55 · Aftercare only | $2.04 | $2.09 | $2.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.38 Median $1.41 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.38 | $1.41 | $1.82 |
Where Missouri sits
The same service costs 4.2 times more in Hawaii 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· 43rd of 51
$11.22
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.