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 $0.18 Median $0.30 Typical High $0.34 | Facility | None | $0.18 | $0.30 | $0.34 |
Aetna Setting Professional Modifier None Typical Low $0.28 Median $0.30 Typical High $0.34 | Professional | None | $0.28 | $0.30 | $0.34 |
Ambetter Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.21 Median $0.25 Typical High $0.37 | Professional | None | $0.21 | $0.25 | $0.37 |
CareSource Setting Facility Modifier None Typical Low $0.56 Median $0.56 Typical High $0.85 | Facility | None | $0.56 | $0.56 | $0.85 |
CareSource Setting Professional Modifier None Typical Low $0.52 Median $0.56 Typical High $0.69 | Professional | None | $0.52 | $0.56 | $0.69 |
Cigna Setting Facility Modifier None Typical Low $0.81 Median $0.81 Typical High $0.81 | Facility | None | $0.81 | $0.81 | $0.81 |
Cigna Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $2.95 | Professional | None | $0.31 | $0.31 | $2.95 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
United Setting Professional Modifier None Typical Low $0.18 Median $0.26 Typical High $0.34 | Professional | None | $0.18 | $0.26 | $0.34 |
6 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 $0.15 Median $0.16 Typical High $0.17 | Professional | 52 · Reduced service | $0.15 | $0.16 | $0.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.06 Median $0.06 Typical High $0.07 | Professional | 53 · Discontinued | $0.06 | $0.06 | $0.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.04 Median $0.05 Typical High $0.05 | Professional | 55 · Aftercare only | $0.04 | $0.05 | $0.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.03 |
Aetna Setting Professional Modifier RR · Rental Typical Low $0.03 Median $0.03 Typical High $0.04 | Professional | RR · Rental | $0.03 | $0.03 | $0.04 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.19 Median $0.20 Typical High $0.25 | Professional | UE · Used equipment | $0.19 | $0.20 | $0.25 |
Where Kentucky sits
The same service costs 4.6 times more in Hawaii than in Rhode Island. 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
$0.28
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.