How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $6.92 Median $11.48 Typical High $13.18 | Facility | None | $6.92 | $11.48 | $13.18 |
Aetna Setting Professional Modifier None Typical Low $6.92 Median $12.88 Typical High $13.18 | Professional | None | $6.92 | $12.88 | $13.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $14.13 | Professional | None | $9.33 | $9.33 | $14.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.93 Median $0.93 Typical High $0.93 | Professional | RR · Rental | $0.93 | $0.93 | $0.93 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7.08 Median $7.08 Typical High $9.33 | Professional | UE · Used equipment | $7.08 | $7.08 | $9.33 |
CareSource Setting Facility Modifier None Typical Low $13.49 Median $18.62 Typical High $30.20 | Facility | None | $13.49 | $18.62 | $30.20 |
CareSource Setting Professional Modifier None Typical Low $20.89 Median $25.70 Typical High $33.11 | Professional | None | $20.89 | $25.70 | $33.11 |
Cigna Setting Facility Modifier None Typical Low $8.91 Median $12.30 Typical High $28.84 | Facility | None | $8.91 | $12.30 | $28.84 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $12.30 Typical High $97.72 | Professional | None | $10.47 | $12.30 | $97.72 |
Molina Setting Professional Modifier None Typical Low $11.48 Median $14.79 Typical High $29.51 | Professional | None | $11.48 | $14.79 | $29.51 |
United Setting Professional Modifier None Typical Low $6.03 Median $9.33 Typical High $13.80 | Professional | None | $6.03 | $9.33 | $13.80 |
2 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 $1.20 Median $1.95 Typical High $2.00 | Professional | 55 · Aftercare only | $1.20 | $1.95 | $2.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.79 Median $1.32 Typical High $1.32 | Professional | 56 · Pre-op care only | $0.79 | $1.32 | $1.32 |
Where Kentucky sits
The same service costs 3.0 times more in Hawaii 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· 40th of 51
$10.47
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.