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 $12.30 Median $20.42 Typical High $23.44 | Facility | None | $12.30 | $20.42 | $23.44 |
Aetna Setting Professional Modifier None Typical Low $13.80 Median $22.91 Typical High $23.44 | Professional | None | $13.80 | $22.91 | $23.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $25.12 | Professional | None | $16.60 | $16.60 | $25.12 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.66 Median $1.66 Typical High $1.66 | Professional | RR · Rental | $1.66 | $1.66 | $1.66 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | UE · Used equipment | $12.59 | $12.59 | $12.59 |
CareSource Setting Facility Modifier None Typical Low $23.99 Median $33.11 Typical High $53.70 | Facility | None | $23.99 | $33.11 | $53.70 |
CareSource Setting Professional Modifier None Typical Low $37.15 Median $45.71 Typical High $58.88 | Professional | None | $37.15 | $45.71 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $18.20 Median $21.88 Typical High $51.29 | Facility | None | $18.20 | $21.88 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $21.88 Typical High $173.78 | Professional | None | $18.62 | $21.88 | $173.78 |
Molina Setting Professional Modifier None Typical Low $20.42 Median $26.30 Typical High $52.48 | Professional | None | $20.42 | $26.30 | $52.48 |
United Setting Professional Modifier None Typical Low $10.96 Median $16.60 Typical High $24.55 | Professional | None | $10.96 | $16.60 | $24.55 |
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 $2.04 Median $3.47 Typical High $3.55 | Professional | 55 · Aftercare only | $2.04 | $3.47 | $3.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.38 Median $2.29 Typical High $2.34 | Professional | 56 · Pre-op care only | $1.38 | $2.29 | $2.34 |
Where Kentucky sits
The same service costs 2.9 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· 42nd of 51
$18.62
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.