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 $4.07 Median $6.92 Typical High $7.76 | Facility | None | $4.07 | $6.92 | $7.76 |
Aetna Setting Professional Modifier None Typical Low $4.07 Median $7.59 Typical High $7.76 | Professional | None | $4.07 | $7.59 | $7.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.17 Median $6.46 Typical High $8.32 | Professional | None | $6.17 | $6.46 | $8.32 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.62 Median $0.62 Typical High $0.62 | Professional | RR · Rental | $0.62 | $0.62 | $0.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.57 Median $4.57 Typical High $6.46 | Professional | UE · Used equipment | $4.57 | $4.57 | $6.46 |
CareSource Setting Facility Modifier None Typical Low $9.12 Median $12.30 Typical High $17.78 | Facility | None | $9.12 | $12.30 | $17.78 |
CareSource Setting Professional Modifier None Typical Low $12.30 Median $13.49 Typical High $18.20 | Professional | None | $12.30 | $13.49 | $18.20 |
Cigna Setting Facility Modifier None Typical Low $7.41 Median $7.76 Typical High $16.98 | Facility | None | $7.41 | $7.76 | $16.98 |
Cigna Setting Professional Modifier None Typical Low $6.31 Median $7.76 Typical High $60.26 | Professional | None | $6.31 | $7.76 | $60.26 |
Molina Setting Professional Modifier None Typical Low $7.24 Median $9.12 Typical High $17.38 | Professional | None | $7.24 | $9.12 | $17.38 |
United Setting Professional Modifier None Typical Low $3.98 Median $5.50 Typical High $8.13 | Professional | None | $3.98 | $5.50 | $8.13 |
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 $0.62 Median $1.17 Typical High $1.17 | Professional | 55 · Aftercare only | $0.62 | $1.17 | $1.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.54 Median $0.78 Typical High $0.78 | Professional | 56 · Pre-op care only | $0.54 | $0.78 | $0.78 |
Where Kentucky sits
The same service costs 2.0 times more in Montana than in Florida. 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
$6.46
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.