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 $0.95 Median $1.10 Typical High $1.74 | Facility | None | $0.95 | $1.10 | $1.74 |
Aetna Setting Professional Modifier None Typical Low $0.95 Median $1.10 Typical High $1.38 | Professional | None | $0.95 | $1.10 | $1.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.51 Median $3.98 Typical High $3.98 | Professional | None | $2.51 | $3.98 | $3.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.40 Median $3.02 Typical High $3.98 | Professional | UE · Used equipment | $2.40 | $3.02 | $3.98 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $12.88 | Professional | None | $3.98 | $3.98 | $12.88 |
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 $0.87 Median $1.12 Typical High $1.66 | Professional | None | $0.87 | $1.12 | $1.66 |
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 $0.14 Median $0.16 Typical High $0.21 | Professional | 55 · Aftercare only | $0.14 | $0.16 | $0.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.11 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.10 | $0.11 | $0.14 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.32 Median $0.32 Typical High $0.32 | Professional | RR · Rental | $0.32 | $0.32 | $0.32 |
Where Kentucky sits
The same service costs 6.0 times more in Minnesota 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· 4th of 51
$3.39
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.