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 $3.09 Median $6.46 Typical High $7.24 | Facility | None | $3.09 | $6.46 | $7.24 |
Aetna Setting Professional Modifier None Typical Low $3.24 Median $7.24 Typical High $7.24 | Professional | None | $3.24 | $7.24 | $7.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.75 Median $6.03 Typical High $7.76 | Professional | None | $5.75 | $6.03 | $7.76 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.56 Median $0.56 Typical High $0.56 | Professional | RR · Rental | $0.56 | $0.56 | $0.56 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.27 Median $4.27 Typical High $6.03 | Professional | UE · Used equipment | $4.27 | $4.27 | $6.03 |
CareSource Setting Facility Modifier None Typical Low $7.41 Median $10.23 Typical High $16.60 | Facility | None | $7.41 | $10.23 | $16.60 |
CareSource Setting Professional Modifier None Typical Low $11.48 Median $14.13 Typical High $18.20 | Professional | None | $11.48 | $14.13 | $18.20 |
Cigna Setting Facility Modifier None Typical Low $6.92 Median $7.59 Typical High $15.85 | Facility | None | $6.92 | $7.59 | $15.85 |
Cigna Setting Professional Modifier None Typical Low $5.89 Median $7.41 Typical High $56.23 | Professional | None | $5.89 | $7.41 | $56.23 |
Molina Setting Professional Modifier None Typical Low $6.76 Median $8.51 Typical High $16.22 | Professional | None | $6.76 | $8.51 | $16.22 |
United Setting Professional Modifier None Typical Low $3.72 Median $5.13 Typical High $7.59 | Professional | None | $3.72 | $5.13 | $7.59 |
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 $0.76 Median $1.10 Typical High $1.10 | Professional | 55 · Aftercare only | $0.76 | $1.10 | $1.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.31 Median $0.72 Typical High $0.72 | Professional | 56 · Pre-op care only | $0.31 | $0.72 | $0.72 |
Where Kentucky sits
The same service costs 2.1 times more in Idaho 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· 41st of 51
$6.03
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.