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 $22.39 Median $36.31 Typical High $43.65 | Facility | None | $22.39 | $36.31 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $42.66 Typical High $43.65 | Professional | None | $26.30 | $42.66 | $43.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $28.84 Median $30.90 Typical High $44.67 | Professional | None | $28.84 | $30.90 | $44.67 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | RR · Rental | $2.88 | $2.88 | $2.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $21.88 Median $21.88 Typical High $22.91 | Professional | UE · Used equipment | $21.88 | $21.88 | $22.91 |
CareSource Setting Facility Modifier None Typical Low $42.66 Median $58.88 Typical High $95.50 | Facility | None | $42.66 | $58.88 | $95.50 |
CareSource Setting Professional Modifier None Typical Low $66.07 Median $81.28 Typical High $104.71 | Professional | None | $66.07 | $81.28 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $91.20 | Facility | None | $40.74 | $40.74 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $40.74 Typical High $323.59 | Professional | None | $34.67 | $40.74 | $323.59 |
Molina Setting Professional Modifier None Typical Low $38.02 Median $48.98 Typical High $93.33 | Professional | None | $38.02 | $48.98 | $93.33 |
United Setting Professional Modifier None Typical Low $21.88 Median $29.51 Typical High $42.66 | Professional | None | $21.88 | $29.51 | $42.66 |
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 $3.89 Median $6.31 Typical High $6.61 | Professional | 55 · Aftercare only | $3.89 | $6.31 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $4.17 Typical High $4.37 | Professional | 56 · Pre-op care only | $2.63 | $4.17 | $4.37 |
Where Kentucky sits
The same service costs 3.0 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· 49th of 51
$31.62
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.