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 $3.31 Median $5.50 Typical High $5.62 | Facility | None | $3.31 | $5.50 | $5.62 |
Aetna Setting Professional Modifier None Typical Low $5.25 Median $5.50 Typical High $6.03 | Professional | None | $5.25 | $5.50 | $6.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.63 Median $4.17 Typical High $6.76 | Professional | None | $3.63 | $4.17 | $6.76 |
CareSource Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Facility | None | $10.00 | $10.00 | $10.00 |
CareSource Setting Professional Modifier None Typical Low $10.72 Median $12.59 Typical High $15.85 | Professional | None | $10.72 | $12.59 | $15.85 |
Cigna Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Facility | None | $13.80 | $13.80 | $13.80 |
Cigna Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $46.77 | Professional | None | $5.13 | $5.13 | $46.77 |
Molina Setting Professional Modifier None Typical Low $7.08 Median $14.45 Typical High $14.45 | Professional | None | $7.08 | $14.45 | $14.45 |
United Setting Professional Modifier None Typical Low $3.31 Median $4.47 Typical High $6.03 | Professional | None | $3.31 | $4.47 | $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 $0.79 Median $0.81 Typical High $0.89 | Professional | 55 · Aftercare only | $0.79 | $0.81 | $0.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.55 Typical High $0.60 | Professional | 56 · Pre-op care only | $0.52 | $0.55 | $0.60 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.42 Median $0.42 Typical High $0.42 | Professional | RR · Rental | $0.42 | $0.42 | $0.42 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.75 Median $3.09 Typical High $3.63 | Professional | UE · Used equipment | $2.75 | $3.09 | $3.63 |
Where Kentucky sits
The same service costs 2.7 times more in Hawaii than in Colorado. 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· 47th of 51
$5.01
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.