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 $2.04 Median $2.09 Typical High $3.09 | Facility | None | $2.04 | $2.09 | $3.09 |
Aetna Setting Professional Modifier None Typical Low $2.04 Median $2.09 Typical High $2.82 | Professional | None | $2.04 | $2.09 | $2.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.05 Median $1.86 Typical High $2.51 | Professional | None | $1.05 | $1.86 | $2.51 |
CareSource Setting Facility Modifier None Typical Low $3.72 Median $5.01 Typical High $5.25 | Facility | None | $3.72 | $5.01 | $5.25 |
CareSource Setting Professional Modifier None Typical Low $3.72 Median $3.98 Typical High $5.25 | Professional | None | $3.72 | $3.98 | $5.25 |
Cigna Setting Facility Modifier None Typical Low $6.61 Median $6.61 Typical High $6.61 | Facility | None | $6.61 | $6.61 | $6.61 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $19.95 | Professional | None | $2.24 | $2.24 | $19.95 |
Molina Setting Professional Modifier None Typical Low $2.24 Median $5.37 Typical High $5.37 | Professional | None | $2.24 | $5.37 | $5.37 |
United Setting Professional Modifier None Typical Low $1.23 Median $1.86 Typical High $2.29 | Professional | None | $1.23 | $1.86 | $2.29 |
7 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 $1.02 Median $1.20 Typical High $1.41 | Professional | 52 · Reduced service | $1.02 | $1.20 | $1.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.41 Median $0.48 Typical High $0.56 | Professional | 53 · Discontinued | $0.41 | $0.48 | $0.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.31 Median $0.36 Typical High $0.42 | Professional | 55 · Aftercare only | $0.31 | $0.36 | $0.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.24 Typical High $0.28 | Professional | 56 · Pre-op care only | $0.21 | $0.24 | $0.28 |
Aetna Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | AU · Urologic/ostomy supply | $1.20 | $1.20 | $1.20 |
Anthem BCBS Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $3.47 Median $3.80 Typical High $6.17 | Professional | AU · Urologic/ostomy supply | $3.47 | $3.80 | $6.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.79 Median $1.41 Typical High $1.86 | Professional | UE · Used equipment | $0.79 | $1.41 | $1.86 |
Where Kentucky sits
The same service costs 4.4 times more in Minnesota than in New Hampshire. 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· 48th of 51
$1.86
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.