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 $4.27 Median $7.08 Typical High $8.13 | Facility | None | $4.27 | $7.08 | $8.13 |
Aetna Setting Professional Modifier None Typical Low $4.27 Median $7.76 Typical High $8.13 | Professional | None | $4.27 | $7.76 | $8.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.31 Median $6.76 Typical High $8.51 | Professional | None | $6.31 | $6.76 | $8.51 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.63 Median $0.63 Typical High $0.63 | Professional | RR · Rental | $0.63 | $0.63 | $0.63 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.79 Median $4.79 Typical High $6.76 | Professional | UE · Used equipment | $4.79 | $4.79 | $6.76 |
CareSource Setting Facility Modifier None Typical Low $8.13 Median $11.48 Typical High $18.20 | Facility | None | $8.13 | $11.48 | $18.20 |
CareSource Setting Professional Modifier None Typical Low $12.59 Median $15.85 Typical High $20.42 | Professional | None | $12.59 | $15.85 | $20.42 |
Cigna Setting Facility Modifier None Typical Low $7.59 Median $7.94 Typical High $17.38 | Facility | None | $7.59 | $7.94 | $17.38 |
Cigna Setting Professional Modifier None Typical Low $6.46 Median $7.94 Typical High $61.66 | Professional | None | $6.46 | $7.94 | $61.66 |
Molina Setting Professional Modifier None Typical Low $7.41 Median $9.33 Typical High $18.20 | Professional | None | $7.41 | $9.33 | $18.20 |
United Setting Professional Modifier None Typical Low $4.17 Median $5.75 Typical High $8.32 | Professional | None | $4.17 | $5.75 | $8.32 |
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 $0.83 Median $1.20 Typical High $1.20 | Professional | 55 · Aftercare only | $0.83 | $1.20 | $1.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.55 Median $0.79 Typical High $0.81 | Professional | 56 · Pre-op care only | $0.55 | $0.79 | $0.81 |
Where Kentucky sits
The same service costs 2.1 times more in Idaho than in New Jersey. 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· 43rd of 51
$6.76
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.