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 $0.74 Median $1.07 Typical High $1.45 | Facility | None | $0.74 | $1.07 | $1.45 |
Aetna Setting Professional Modifier None Typical Low $0.60 Median $1.07 Typical High $1.45 | Professional | None | $0.60 | $1.07 | $1.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.95 Median $1.17 Typical High $1.29 | Professional | None | $0.95 | $1.17 | $1.29 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.83 Median $0.89 Typical High $1.17 | Professional | UE · Used equipment | $0.83 | $0.89 | $1.17 |
CareSource Setting Facility Modifier None Typical Low $1.23 Median $1.70 Typical High $2.75 | Facility | None | $1.23 | $1.70 | $2.75 |
CareSource Setting Professional Modifier None Typical Low $1.91 Median $2.40 Typical High $3.02 | Professional | None | $1.91 | $2.40 | $3.02 |
Cigna Setting Facility Modifier None Typical Low $0.72 Median $1.35 Typical High $3.16 | Facility | None | $0.72 | $1.35 | $3.16 |
Cigna Setting Professional Modifier None Typical Low $1.12 Median $1.35 Typical High $11.22 | Professional | None | $1.12 | $1.35 | $11.22 |
Molina Setting Professional Modifier None Typical Low $1.12 Median $1.41 Typical High $2.69 | Professional | None | $1.12 | $1.41 | $2.69 |
United Setting Professional Modifier None Typical Low $0.63 Median $0.87 Typical High $1.32 | Professional | None | $0.63 | $0.87 | $1.32 |
3 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 $0.11 Median $0.21 Typical High $0.21 | Professional | 55 · Aftercare only | $0.11 | $0.21 | $0.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.14 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.07 | $0.14 | $0.14 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | RR · Rental | $0.11 | $0.11 | $0.11 |
Where Kentucky sits
The same service costs 5.8 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· 37th of 51
$1.17
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.