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 $7.41 Median $12.59 Typical High $14.45 | Facility | None | $7.41 | $12.59 | $14.45 |
Aetna Setting Professional Modifier None Typical Low $7.41 Median $13.49 Typical High $14.45 | Professional | None | $7.41 | $13.49 | $14.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $15.14 | Professional | None | $10.00 | $10.00 | $15.14 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | RR · Rental | $1.00 | $1.00 | $1.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | UE · Used equipment | $7.59 | $7.59 | $7.59 |
CareSource Setting Facility Modifier None Typical Low $14.45 Median $19.95 Typical High $32.36 | Facility | None | $14.45 | $19.95 | $32.36 |
CareSource Setting Professional Modifier None Typical Low $22.39 Median $28.18 Typical High $35.48 | Professional | None | $22.39 | $28.18 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $9.55 Median $13.49 Typical High $30.90 | Facility | None | $9.55 | $13.49 | $30.90 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $13.49 Typical High $107.15 | Professional | None | $11.48 | $13.49 | $107.15 |
Molina Setting Professional Modifier None Typical Low $12.59 Median $15.85 Typical High $31.62 | Professional | None | $12.59 | $15.85 | $31.62 |
United Setting Professional Modifier None Typical Low $6.61 Median $10.00 Typical High $14.79 | Professional | None | $6.61 | $10.00 | $14.79 |
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 $1.35 Median $2.14 Typical High $2.14 | Professional | 55 · Aftercare only | $1.35 | $2.14 | $2.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.89 Median $1.38 Typical High $1.45 | Professional | 56 · Pre-op care only | $0.89 | $1.38 | $1.45 |
Where Kentucky sits
The same service costs 2.8 times more in Hawaii than in Connecticut. 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· 44th of 51
$11.22
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.