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 $18.20 Median $18.62 Typical High $18.62 | Facility | None | $18.20 | $18.62 | $18.62 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $18.20 Typical High $19.50 | Professional | None | $17.78 | $18.20 | $19.50 |
Ambetter Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $19.50 | Professional | None | $16.60 | $16.60 | $19.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.48 Median $13.49 Typical High $18.62 | Professional | None | $11.48 | $13.49 | $18.62 |
CareSource Setting Facility Modifier None Typical Low $14.79 Median $18.20 Typical High $27.54 | Facility | None | $14.79 | $18.20 | $27.54 |
CareSource Setting Professional Modifier None Typical Low $16.98 Median $21.88 Typical High $27.54 | Professional | None | $16.98 | $21.88 | $27.54 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $19.05 Typical High $104.71 | Professional | None | $17.38 | $19.05 | $104.71 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Professional Modifier None Typical Low $15.85 Median $19.05 Typical High $24.55 | Professional | None | $15.85 | $19.05 | $24.55 |
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 $8.91 Median $9.12 Typical High $9.33 | Professional | 52 · Reduced service | $8.91 | $9.12 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $3.63 Typical High $3.72 | Professional | 53 · Discontinued | $3.55 | $3.63 | $3.72 |
Ambetter Setting Professional Modifier GO · Occupational therapy plan Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | GO · Occupational therapy plan | $15.49 | $15.49 | $15.49 |
Ambetter Setting Professional Modifier GP · Physical therapy plan Typical Low $15.49 Median $15.49 Typical High $15.85 | Professional | GP · Physical therapy plan | $15.49 | $15.49 | $15.85 |
Where Kentucky sits
The same service costs 2.3 times more in North Dakota than in Kentucky. 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· 51st of 51
$17.38
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.