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 $3.55 Median $5.25 Typical High $6.92 | Facility | None | $3.55 | $5.25 | $6.92 |
Aetna Setting Professional Modifier None Typical Low $5.25 Median $5.62 Typical High $6.92 | Professional | None | $5.25 | $5.62 | $6.92 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.89 Median $4.79 Typical High $6.46 | Professional | None | $3.89 | $4.79 | $6.46 |
CareSource Setting Facility Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Facility | None | $9.55 | $9.55 | $9.55 |
CareSource Setting Professional Modifier None Typical Low $10.23 Median $11.75 Typical High $15.14 | Professional | None | $10.23 | $11.75 | $15.14 |
Cigna Setting Facility Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Facility | None | $14.79 | $14.79 | $14.79 |
Cigna Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $52.48 | Professional | None | $5.50 | $5.50 | $52.48 |
Molina Setting Professional Modifier None Typical Low $6.76 Median $13.49 Typical High $13.49 | Professional | None | $6.76 | $13.49 | $13.49 |
United Setting Professional Modifier None Typical Low $3.16 Median $4.68 Typical High $6.03 | Professional | None | $3.16 | $4.68 | $6.03 |
4 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 $0.78 Median $0.85 Typical High $1.05 | Professional | 55 · Aftercare only | $0.78 | $0.85 | $1.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.56 Typical High $0.69 | Professional | 56 · Pre-op care only | $0.52 | $0.56 | $0.69 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.46 Median $0.46 Typical High $0.46 | Professional | RR · Rental | $0.46 | $0.46 | $0.46 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.47 Median $3.47 Typical High $4.68 | Professional | UE · Used equipment | $3.47 | $3.47 | $4.68 |
Where Kentucky sits
The same service costs 3.3 times more in Hawaii than in Utah. 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· 49th of 51
$4.79
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.