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 $1.58 Median $2.69 Typical High $3.02 | Facility | None | $1.58 | $2.69 | $3.02 |
Aetna Setting Professional Modifier None Typical Low $2.63 Median $2.88 Typical High $3.02 | Professional | None | $2.63 | $2.88 | $3.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.78 Median $2.14 Typical High $3.24 | Professional | None | $1.78 | $2.14 | $3.24 |
CareSource Setting Facility Modifier None Typical Low $4.79 Median $4.79 Typical High $4.79 | Facility | None | $4.79 | $4.79 | $4.79 |
CareSource Setting Professional Modifier None Typical Low $5.13 Median $5.89 Typical High $7.59 | Professional | None | $5.13 | $5.89 | $7.59 |
Cigna Setting Facility Modifier None Typical Low $6.61 Median $6.61 Typical High $6.61 | Facility | None | $6.61 | $6.61 | $6.61 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $23.44 | Professional | None | $2.00 | $2.00 | $23.44 |
Molina Setting Professional Modifier None Typical Low $3.39 Median $6.76 Typical High $6.76 | Professional | None | $3.39 | $6.76 | $6.76 |
United Setting Professional Modifier None Typical Low $1.58 Median $2.14 Typical High $2.88 | Professional | None | $1.58 | $2.14 | $2.88 |
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 $1.32 Median $1.45 Typical High $1.51 | Professional | 52 · Reduced service | $1.32 | $1.45 | $1.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.52 Median $0.56 Typical High $0.62 | Professional | 53 · Discontinued | $0.52 | $0.56 | $0.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.39 Median $0.43 Typical High $0.46 | Professional | 55 · Aftercare only | $0.39 | $0.43 | $0.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.26 Median $0.28 Typical High $0.31 | Professional | 56 · Pre-op care only | $0.26 | $0.28 | $0.31 |
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 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.51 Median $1.62 Typical High $2.04 | Professional | UE · Used equipment | $1.51 | $1.62 | $2.04 |
Where Kentucky sits
The same service costs 2.6 times more in Hawaii than in Maine. 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· 43rd of 51
$2.14
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.