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 $54.95 Median $54.95 Typical High $74.13 | Facility | None | $54.95 | $54.95 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $56.23 Typical High $74.13 | Professional | None | $54.95 | $56.23 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $363.08 | Facility | None | $79.43 | $79.43 | $363.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.11 Median $51.29 Typical High $58.88 | Professional | None | $33.11 | $51.29 | $58.88 |
BCBS Kansas City Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Medica Setting Facility Modifier None Typical Low $57.54 Median $100.00 Typical High $363.08 | Facility | None | $57.54 | $100.00 | $363.08 |
Medica Setting Professional Modifier None Typical Low $28.84 Median $38.90 Typical High $389.05 | Professional | None | $28.84 | $38.90 | $389.05 |
United Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
United Setting Professional Modifier None Typical Low $19.05 Median $35.48 Typical High $46.77 | Professional | None | $19.05 | $35.48 | $46.77 |
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 $27.54 Median $28.18 Typical High $37.15 | Professional | 52 · Reduced service | $27.54 | $28.18 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $11.22 Typical High $14.79 | Professional | 53 · Discontinued | $10.96 | $11.22 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.51 Typical High $10.96 | Professional | 55 · Aftercare only | $8.32 | $8.51 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.62 Typical High $7.41 | Professional | 56 · Pre-op care only | $5.50 | $5.62 | $7.41 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $29.51 Median $43.65 Typical High $66.07 | Professional | UE · Used equipment | $29.51 | $43.65 | $66.07 |
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· 35th of 51
$44.67
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.