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 $316.23 Median $380.19 Typical High $380.19 | Facility | None | $316.23 | $380.19 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $380.19 | Professional | None | $316.23 | $380.19 | $380.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.00 Median $12.30 Typical High $426.58 | Professional | None | $10.00 | $12.30 | $426.58 |
CareSource Setting Facility Modifier None Typical Low $81,283.05 Median $104,712.85 Typical High $123,026.88 | Facility | None | $81,283.05 | $104,712.85 | $123,026.88 |
CareSource Setting Professional Modifier None Typical Low $85,113.80 Median $109,647.82 Typical High $144,543.98 | Professional | None | $85,113.80 | $109,647.82 | $144,543.98 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $1,000.00 Typical High $1,000.00 | Professional | None | $109.65 | $1,000.00 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $44.67 | Professional | None | $30.20 | $30.20 | $44.67 |
2 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 $158.49 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $158.49 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $63.10 | $75.86 | $75.86 |
Where Kentucky sits
The same service costs 25.1 times more in Vermont than in Michigan. 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· 40th of 51
$107
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.