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 $2.19 Median $2.19 Typical High $2.51 | Facility | None | $2.19 | $2.19 | $2.51 |
Aetna Setting Professional Modifier None Typical Low $1.07 Median $2.34 Typical High $2.51 | Professional | None | $1.07 | $2.34 | $2.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.95 Median $2.04 Typical High $2.63 | Professional | None | $1.95 | $2.04 | $2.63 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.45 Median $1.55 Typical High $2.04 | Professional | UE · Used equipment | $1.45 | $1.55 | $2.04 |
CareSource Setting Facility Modifier None Typical Low $2.51 Median $3.55 Typical High $5.62 | Facility | None | $2.51 | $3.55 | $5.62 |
CareSource Setting Professional Modifier None Typical Low $3.89 Median $4.90 Typical High $6.31 | Professional | None | $3.89 | $4.90 | $6.31 |
Cigna Setting Facility Modifier None Typical Low $2.34 Median $2.51 Typical High $5.37 | Facility | None | $2.34 | $2.51 | $5.37 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $2.51 Typical High $19.50 | Professional | None | $2.00 | $2.51 | $19.50 |
Molina Setting Professional Modifier None Typical Low $2.29 Median $2.88 Typical High $5.62 | Professional | None | $2.29 | $2.88 | $5.62 |
United Setting Professional Modifier None Typical Low $1.26 Median $1.74 Typical High $2.57 | Professional | None | $1.26 | $1.74 | $2.57 |
5 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 52 · Reduced service Typical Low $1.07 Median $1.23 Typical High $1.26 | Professional | 52 · Reduced service | $1.07 | $1.23 | $1.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.43 Median $0.50 Typical High $0.50 | Professional | 53 · Discontinued | $0.43 | $0.50 | $0.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.32 Median $0.37 Typical High $0.38 | Professional | 55 · Aftercare only | $0.32 | $0.37 | $0.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.25 Typical High $0.25 | Professional | 56 · Pre-op care only | $0.22 | $0.25 | $0.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | RR · Rental | $0.20 | $0.20 | $0.20 |
Where Kentucky sits
The same service costs 2.2 times more in Kansas 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
$2.04
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.