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 $8.71 Median $14.13 Typical High $16.22 | Facility | None | $8.71 | $14.13 | $16.22 |
Aetna Setting Professional Modifier None Typical Low $13.80 Median $15.14 Typical High $16.22 | Professional | None | $13.80 | $15.14 | $16.22 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.71 Median $11.75 Typical High $16.60 | Professional | None | $8.71 | $11.75 | $16.60 |
CareSource Setting Facility Modifier None Typical Low $25.12 Median $33.88 Typical High $35.48 | Facility | None | $25.12 | $33.88 | $35.48 |
CareSource Setting Professional Modifier None Typical Low $25.12 Median $26.92 Typical High $35.48 | Professional | None | $25.12 | $26.92 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $125.89 | Professional | None | $15.14 | $15.14 | $125.89 |
Molina Setting Professional Modifier None Typical Low $20.42 Median $36.31 Typical High $36.31 | Professional | None | $20.42 | $36.31 | $36.31 |
United Setting Professional Modifier None Typical Low $8.71 Median $11.75 Typical High $16.60 | Professional | None | $8.71 | $11.75 | $16.60 |
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 $6.92 Median $7.59 Typical High $8.13 | Professional | 52 · Reduced service | $6.92 | $7.59 | $8.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.75 Median $3.02 Typical High $3.24 | Professional | 53 · Discontinued | $2.75 | $3.02 | $3.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.09 Median $2.29 Typical High $2.40 | Professional | 55 · Aftercare only | $2.09 | $2.29 | $2.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.38 Median $1.51 Typical High $1.62 | Professional | 56 · Pre-op care only | $1.38 | $1.51 | $1.62 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | RR · Rental | $1.29 | $1.29 | $1.29 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | UE · Used equipment | $9.55 | $9.55 | $9.55 |
Where Kentucky sits
The same service costs 2.6 times more in Hawaii 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
$12.30
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.