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 $2.82 Median $4.68 Typical High $5.37 | Facility | None | $2.82 | $4.68 | $5.37 |
Aetna Setting Professional Modifier None Typical Low $3.63 Median $5.37 Typical High $5.37 | Professional | None | $3.63 | $5.37 | $5.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.17 Median $4.47 Typical High $5.62 | Professional | None | $4.17 | $4.47 | $5.62 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.42 Median $0.42 Typical High $0.42 | Professional | RR · Rental | $0.42 | $0.42 | $0.42 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.16 Median $3.16 Typical High $4.17 | Professional | UE · Used equipment | $3.16 | $3.16 | $4.17 |
CareSource Setting Facility Modifier None Typical Low $5.50 Median $7.59 Typical High $12.02 | Facility | None | $5.50 | $7.59 | $12.02 |
CareSource Setting Professional Modifier None Typical Low $8.32 Median $10.47 Typical High $13.49 | Professional | None | $8.32 | $10.47 | $13.49 |
Cigna Setting Facility Modifier None Typical Low $5.01 Median $5.37 Typical High $11.75 | Facility | None | $5.01 | $5.37 | $11.75 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $5.37 Typical High $41.69 | Professional | None | $4.27 | $5.37 | $41.69 |
Molina Setting Professional Modifier None Typical Low $5.25 Median $6.61 Typical High $12.02 | Professional | None | $5.25 | $6.61 | $12.02 |
United Setting Professional Modifier None Typical Low $2.75 Median $3.80 Typical High $5.50 | Professional | None | $2.75 | $3.80 | $5.50 |
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 $0.42 Median $0.79 Typical High $0.79 | Professional | 55 · Aftercare only | $0.42 | $0.79 | $0.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.37 Median $0.52 Typical High $0.54 | Professional | 56 · Pre-op care only | $0.37 | $0.52 | $0.54 |
Where Kentucky sits
The same service costs 2.1 times more in Hawaii than in Delaware. 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· 42nd of 51
$4.47
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.