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 $1.17 Median $1.91 Typical High $2.14 | Facility | None | $1.17 | $1.91 | $2.14 |
Aetna Setting Professional Modifier None Typical Low $1.86 Median $2.04 Typical High $2.14 | Professional | None | $1.86 | $2.04 | $2.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.17 Median $1.55 Typical High $2.19 | Professional | None | $1.17 | $1.55 | $2.19 |
CareSource Setting Facility Modifier None Typical Low $3.39 Median $4.57 Typical High $4.68 | Facility | None | $3.39 | $4.57 | $4.68 |
CareSource Setting Professional Modifier None Typical Low $3.39 Median $3.63 Typical High $4.79 | Professional | None | $3.39 | $3.63 | $4.79 |
Cigna Setting Facility Modifier None Typical Low $4.68 Median $4.68 Typical High $4.68 | Facility | None | $4.68 | $4.68 | $4.68 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $16.98 | Professional | None | $2.00 | $2.00 | $16.98 |
Molina Setting Professional Modifier None Typical Low $2.75 Median $4.90 Typical High $4.90 | Professional | None | $2.75 | $4.90 | $4.90 |
United Setting Professional Modifier None Typical Low $1.12 Median $1.55 Typical High $2.19 | Professional | None | $1.12 | $1.55 | $2.19 |
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 $0.93 Median $1.02 Typical High $1.07 | Professional | 52 · Reduced service | $0.93 | $1.02 | $1.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.37 Median $0.38 Typical High $0.43 | Professional | 53 · Discontinued | $0.37 | $0.38 | $0.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.28 Median $0.30 Typical High $0.32 | Professional | 55 · Aftercare only | $0.28 | $0.30 | $0.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.20 Typical High $0.22 | Professional | 56 · Pre-op care only | $0.19 | $0.20 | $0.22 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.17 Median $0.17 Typical High $0.17 | Professional | RR · Rental | $0.17 | $0.17 | $0.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | UE · Used equipment | $1.29 | $1.29 | $1.29 |
Where Kentucky sits
The same service costs 2.3 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
$1.66
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.