How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $1,737.80 Median $1,778.28 Typical High $2,137.96 | Facility | None | $1,737.80 | $1,778.28 | $2,137.96 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,584.89 Median $1,737.80 Typical High $2,137.96 | Professional | None (both parts) | $1,584.89 | $1,737.80 | $2,137.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Facility | None | $21.38 | $21.38 | $21.38 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $17.78 Median $21.38 Typical High $2,137.96 | Professional | None (both parts) | $17.78 | $21.38 | $2,137.96 |
CareSource Setting Facility Modifier None Typical Low $2,137.96 Median $28,840.32 Typical High $47,863.01 | Facility | None | $2,137.96 | $28,840.32 | $47,863.01 |
CareSource Setting Professional Modifier None (both parts) Typical Low $2,344.23 Median $2,951.21 Typical High $39,810.72 | Professional | None (both parts) | $2,344.23 | $2,951.21 | $39,810.72 |
Cigna Setting Facility Modifier None Typical Low $1,659.59 Median $3,090.30 Typical High $5,011.87 | Facility | None | $1,659.59 | $3,090.30 | $5,011.87 |
Cigna Setting Facility Modifier TC · Technical part Typical Low $489.78 Median $2,290.87 Typical High $3,311.31 | Facility | TC · Technical part | $489.78 | $2,290.87 | $3,311.31 |
Cigna Setting Professional Modifier None (both parts) Typical Low $10,232.93 Median $10,232.93 Typical High $10,232.93 | Professional | None (both parts) | $10,232.93 | $10,232.93 | $10,232.93 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $10,232.93 Median $10,232.93 Typical High $10,232.93 | Professional | TC · Technical part | $10,232.93 | $10,232.93 | $10,232.93 |
Molina Setting Professional Modifier None (both parts) Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None (both parts) | $100.00 | $100.00 | $100.00 |
United Setting Professional Modifier None (both parts) Typical Low $912.01 Median $1,288.25 Typical High $3,388.44 | Professional | None (both parts) | $912.01 | $1,288.25 | $3,388.44 |
3 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 26 · Professional part Typical Low $1,584.89 Median $1,737.80 Typical High $2,137.96 | Professional | 26 · Professional part | $1,584.89 | $1,737.80 | $2,137.96 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $794.33 Median $870.96 Typical High $1,071.52 | Professional | 52 · Reduced service | $794.33 | $870.96 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $346.74 Typical High $426.58 | Professional | 53 · Discontinued | $316.23 | $346.74 | $426.58 |
Where Kentucky sits
The same service costs 229.1 times more in Texas than in Ohio. 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.
Kentucky· 45th of 51
$1,288
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.