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 $61.66 Median $61.66 Typical High $83.18 | Facility | None | $61.66 | $61.66 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $64.57 Typical High $83.18 | Professional | None | $61.66 | $64.57 | $83.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $407.38 | Facility | None | $89.13 | $89.13 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.02 Median $40.74 Typical High $66.07 | Professional | None | $38.02 | $40.74 | $66.07 |
BCBS Kansas City Setting Professional Modifier None Typical Low $52.48 Median $53.70 Typical High $53.70 | Professional | None | $52.48 | $53.70 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Medica Setting Facility Modifier None Typical Low $64.57 Median $114.82 Typical High $407.38 | Facility | None | $64.57 | $114.82 | $407.38 |
Medica Setting Professional Modifier None Typical Low $32.36 Median $43.65 Typical High $436.52 | Professional | None | $32.36 | $43.65 | $436.52 |
United Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
United Setting Professional Modifier None Typical Low $19.05 Median $39.81 Typical High $52.48 | Professional | None | $19.05 | $39.81 | $52.48 |
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 $30.90 Median $31.62 Typical High $41.69 | Professional | 52 · Reduced service | $30.90 | $31.62 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $12.88 Typical High $16.60 | Professional | 53 · Discontinued | $12.30 | $12.88 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.55 Typical High $12.30 | Professional | 55 · Aftercare only | $9.33 | $9.55 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.46 Typical High $8.32 | Professional | 56 · Pre-op care only | $6.17 | $6.46 | $8.32 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $33.11 Median $48.98 Typical High $74.13 | Professional | UE · Used equipment | $33.11 | $48.98 | $74.13 |
Where Missouri sits
The same service costs 2.8 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· 47th of 51
$40.74
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.