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 $3.09 Median $5.13 Typical High $5.89 | Facility | None | $3.09 | $5.13 | $5.89 |
Aetna Setting Professional Modifier None Typical Low $3.98 Median $5.75 Typical High $5.89 | Professional | None | $3.98 | $5.75 | $5.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.57 Median $4.79 Typical High $6.17 | Professional | None | $4.57 | $4.79 | $6.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.39 Median $3.39 Typical High $4.79 | Professional | UE · Used equipment | $3.39 | $3.39 | $4.79 |
CareSource Setting Facility Modifier None Typical Low $5.89 Median $8.13 Typical High $13.18 | Facility | None | $5.89 | $8.13 | $13.18 |
CareSource Setting Professional Modifier None Typical Low $9.12 Median $11.48 Typical High $14.45 | Professional | None | $9.12 | $11.48 | $14.45 |
Cigna Setting Facility Modifier None Typical Low $5.50 Median $5.75 Typical High $12.59 | Facility | None | $5.50 | $5.75 | $12.59 |
Cigna Setting Professional Modifier None Typical Low $4.68 Median $5.75 Typical High $44.67 | Professional | None | $4.68 | $5.75 | $44.67 |
Molina Setting Professional Modifier None Typical Low $5.37 Median $6.76 Typical High $12.88 | Professional | None | $5.37 | $6.76 | $12.88 |
United Setting Professional Modifier None Typical Low $2.95 Median $4.07 Typical High $6.03 | Professional | None | $2.95 | $4.07 | $6.03 |
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 $2.00 Median $2.88 Typical High $2.95 | Professional | 52 · Reduced service | $2.00 | $2.88 | $2.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.79 Median $1.15 Typical High $1.17 | Professional | 53 · Discontinued | $0.79 | $1.15 | $1.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.47 Median $0.87 Typical High $0.87 | Professional | 55 · Aftercare only | $0.47 | $0.87 | $0.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.31 Median $0.58 Typical High $0.58 | Professional | 56 · Pre-op care only | $0.31 | $0.58 | $0.58 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.46 Median $0.46 Typical High $0.46 | Professional | RR · Rental | $0.46 | $0.46 | $0.46 |
Where Kentucky sits
The same service costs 2.3 times more in Kansas 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· 44th of 51
$4.79
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.