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 $1.70 Median $2.88 Typical High $3.24 | Facility | None | $1.70 | $2.88 | $3.24 |
Aetna Setting Professional Modifier None Typical Low $1.38 Median $2.88 Typical High $3.24 | Professional | None | $1.38 | $2.88 | $3.24 |
Ambetter Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.57 Median $2.69 Typical High $3.47 | Professional | None | $2.57 | $2.69 | $3.47 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | RR · Rental | $0.26 | $0.26 | $0.26 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.91 Median $1.91 Typical High $2.69 | Professional | UE · Used equipment | $1.91 | $1.91 | $2.69 |
CareSource Setting Facility Modifier None Typical Low $3.80 Median $5.13 Typical High $7.41 | Facility | None | $3.80 | $5.13 | $7.41 |
CareSource Setting Professional Modifier None Typical Low $5.13 Median $5.62 Typical High $7.59 | Professional | None | $5.13 | $5.62 | $7.59 |
Cigna Setting Facility Modifier None Typical Low $3.09 Median $3.24 Typical High $7.08 | Facility | None | $3.09 | $3.24 | $7.08 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $3.24 Typical High $25.12 | Professional | None | $2.57 | $3.24 | $25.12 |
Molina Setting Professional Modifier None Typical Low $3.02 Median $3.80 Typical High $7.24 | Professional | None | $3.02 | $3.80 | $7.24 |
United Setting Professional Modifier None Typical Low $1.66 Median $2.29 Typical High $3.39 | Professional | None | $1.66 | $2.29 | $3.39 |
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 $0.25 Median $0.49 Typical High $0.49 | Professional | 55 · Aftercare only | $0.25 | $0.49 | $0.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.17 Median $0.32 Typical High $0.33 | Professional | 56 · Pre-op care only | $0.17 | $0.32 | $0.33 |
Where Kentucky sits
The same service costs 3.2 times more in Kansas than in Missouri. 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· 41st of 51
$2.69
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.