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 $0.08 Median $0.08 Typical High $0.15 | Facility | None | $0.08 | $0.08 | $0.15 |
Aetna Setting Professional Modifier None Typical Low $0.08 Median $0.15 Typical High $0.15 | Professional | None | $0.08 | $0.15 | $0.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.12 Median $0.17 Typical High $1.00 | Professional | None | $0.12 | $0.17 | $1.00 |
CareSource Setting Facility Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Facility | None | $1.32 | $1.32 | $1.32 |
CareSource Setting Professional Modifier None Typical Low $1.41 Median $1.58 Typical High $2.04 | Professional | None | $1.41 | $1.58 | $2.04 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $0.30 Median $0.30 Typical High $1.86 | Professional | None | $0.30 | $0.30 | $1.86 |
Molina Setting Professional Modifier None Typical Low $1.00 Median $30.20 Typical High $1,995.26 | Professional | None | $1.00 | $30.20 | $1,995.26 |
United Setting Professional Modifier None Typical Low $0.12 Median $0.22 Typical High $0.22 | Professional | None | $0.12 | $0.22 | $0.22 |
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 $0.04 Median $0.08 Typical High $0.08 | Professional | 52 · Reduced service | $0.04 | $0.08 | $0.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.02 Median $0.03 Typical High $0.03 | Professional | 53 · Discontinued | $0.02 | $0.03 | $0.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.02 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.11 Median $0.13 Typical High $0.17 | Professional | UE · Used equipment | $0.11 | $0.13 | $0.17 |
Where Kentucky sits
The same service costs 1318.3 times more in Montana than in Missouri. 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· 34th of 51
$0.17
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.