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 $0.32 Median $0.36 Typical High $0.52 | Facility | None | $0.32 | $0.36 | $0.52 |
Aetna Setting Professional Modifier None Typical Low $0.32 Median $0.36 Typical High $0.46 | Professional | None | $0.32 | $0.36 | $0.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.52 Median $1.00 Typical High $1.00 | Professional | None | $0.52 | $1.00 | $1.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.47 Median $0.52 Typical High $1.58 | Professional | UE · Used equipment | $0.47 | $0.52 | $1.58 |
CareSource Setting Facility Modifier None Typical Low $0.58 Median $0.58 Typical High $0.58 | Facility | None | $0.58 | $0.58 | $0.58 |
CareSource Setting Professional Modifier None Typical Low $0.52 Median $0.71 Typical High $1.29 | Professional | None | $0.52 | $0.71 | $1.29 |
Cigna Setting Facility Modifier None Typical Low $0.89 Median $0.89 Typical High $0.89 | Facility | None | $0.89 | $0.89 | $0.89 |
Cigna Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $3.24 | Professional | None | $1.82 | $1.82 | $3.24 |
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 $0.28 Median $0.38 Typical High $0.55 | Professional | None | $0.28 | $0.38 | $0.55 |
3 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 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.07 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.04 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.03 | $0.04 | $0.05 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | RR · Rental | $0.21 | $0.21 | $0.21 |
Where Kentucky sits
The same service costs 190.5 times more in Wyoming 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· 22nd of 51
$0.76
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.