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 $6.61 Median $6.61 Typical High $7.59 | Facility | None | $6.61 | $6.61 | $7.59 |
Aetna Setting Professional Modifier None Typical Low $6.61 Median $7.59 Typical High $7.59 | Professional | None | $6.61 | $7.59 | $7.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.03 Median $6.31 Typical High $8.13 | Professional | None | $6.03 | $6.31 | $8.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.60 Median $0.60 Typical High $0.60 | Professional | RR · Rental | $0.60 | $0.60 | $0.60 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.47 Median $4.47 Typical High $6.03 | Professional | UE · Used equipment | $4.47 | $4.47 | $6.03 |
CareSource Setting Facility Modifier None Typical Low $7.76 Median $10.72 Typical High $17.38 | Facility | None | $7.76 | $10.72 | $17.38 |
CareSource Setting Professional Modifier None Typical Low $12.02 Median $14.79 Typical High $19.05 | Professional | None | $12.02 | $14.79 | $19.05 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $7.59 Typical High $16.60 | Facility | None | $7.08 | $7.59 | $16.60 |
Cigna Setting Professional Modifier None Typical Low $6.03 Median $7.59 Typical High $58.88 | Professional | None | $6.03 | $7.59 | $58.88 |
Molina Setting Professional Modifier None Typical Low $6.92 Median $8.91 Typical High $16.98 | Professional | None | $6.92 | $8.91 | $16.98 |
United Setting Professional Modifier None Typical Low $3.89 Median $5.37 Typical High $7.76 | Professional | None | $3.89 | $5.37 | $7.76 |
4 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 $3.31 Median $3.80 Typical High $3.80 | Professional | 52 · Reduced service | $3.31 | $3.80 | $3.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.32 Median $1.51 Typical High $1.51 | Professional | 53 · Discontinued | $1.32 | $1.51 | $1.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.00 Median $1.12 Typical High $1.12 | Professional | 55 · Aftercare only | $1.00 | $1.12 | $1.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.66 Median $0.76 Typical High $0.76 | Professional | 56 · Pre-op care only | $0.66 | $0.76 | $0.76 |
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
$6.31
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.