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 $3.24 Median $5.37 Typical High $6.17 | Facility | None | $3.24 | $5.37 | $6.17 |
Aetna Setting Professional Modifier None Typical Low $2.63 Median $5.37 Typical High $6.17 | Professional | None | $2.63 | $5.37 | $6.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $6.61 | Professional | None | $4.07 | $4.07 | $6.61 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.09 Median $3.09 Typical High $4.07 | Professional | UE · Used equipment | $3.09 | $3.09 | $4.07 |
CareSource Setting Facility Modifier None Typical Low $6.31 Median $8.71 Typical High $14.13 | Facility | None | $6.31 | $8.71 | $14.13 |
CareSource Setting Professional Modifier None Typical Low $9.77 Median $12.02 Typical High $15.49 | Professional | None | $9.77 | $12.02 | $15.49 |
Cigna Setting Facility Modifier None Typical Low $5.75 Median $7.24 Typical High $13.80 | Facility | None | $5.75 | $7.24 | $13.80 |
Cigna Setting Professional Modifier None Typical Low $4.90 Median $6.17 Typical High $50.12 | Professional | None | $4.90 | $6.17 | $50.12 |
Molina Setting Professional Modifier None Typical Low $5.37 Median $6.92 Typical High $13.80 | Professional | None | $5.37 | $6.92 | $13.80 |
United Setting Professional Modifier None Typical Low $2.82 Median $4.37 Typical High $6.31 | Professional | None | $2.82 | $4.37 | $6.31 |
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 $1.82 Median $3.02 Typical High $3.09 | Professional | 52 · Reduced service | $1.82 | $3.02 | $3.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.72 Median $1.20 Typical High $1.23 | Professional | 53 · Discontinued | $0.72 | $1.20 | $1.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.54 Median $0.89 Typical High $0.93 | Professional | 55 · Aftercare only | $0.54 | $0.89 | $0.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.62 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.36 | $0.62 | $0.62 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.41 Median $0.41 Typical High $0.41 | Professional | RR · Rental | $0.41 | $0.41 | $0.41 |
Where Kentucky sits
The same service costs 2.5 times more in Montana than in New Hampshire. 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· 46th 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.