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 $0.79 Median $0.91 Typical High $5.89 | Facility | None | $0.79 | $0.91 | $5.89 |
Aetna Setting Professional Modifier None Typical Low $0.79 Median $0.91 Typical High $1.20 | Professional | None | $0.79 | $0.91 | $1.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.41 Median $8.51 Typical High $9.12 | Professional | None | $1.41 | $8.51 | $9.12 |
Anthem BCBS Setting Professional Modifier KL · Delivered by mail Typical Low $7.24 Median $9.77 Typical High $11.48 | Professional | KL · Delivered by mail | $7.24 | $9.77 | $11.48 |
CareSource Setting Facility Modifier None Typical Low $1.12 Median $1.12 Typical High $1.58 | Facility | None | $1.12 | $1.12 | $1.58 |
CareSource Setting Professional Modifier None Typical Low $1.12 Median $1.23 Typical High $1.74 | Professional | None | $1.12 | $1.23 | $1.74 |
Cigna Setting Facility Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Facility | None | $12.30 | $12.30 | $12.30 |
Cigna Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $13.49 | Professional | None | $1.02 | $1.02 | $13.49 |
Molina Setting Professional Modifier None Typical Low $1.48 Median $2.00 Typical High $2.00 | Professional | None | $1.48 | $2.00 | $2.00 |
United Setting Professional Modifier None Typical Low $0.56 Median $6.92 Typical High $9.55 | Professional | None | $0.56 | $6.92 | $9.55 |
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 $0.12 Median $0.14 Typical High $0.16 | Professional | 55 · Aftercare only | $0.12 | $0.14 | $0.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.09 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.08 | $0.09 | $0.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.89 Median $1.07 Typical High $5.75 | Professional | UE · Used equipment | $0.89 | $1.07 | $5.75 |
Where Kentucky sits
The same service costs 7.4 times more in Kentucky than in Delaware. 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· 1st of 51
$7.59
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.