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 $1.48 Median $2.14 Typical High $2.82 | Facility | None | $1.48 | $2.14 | $2.82 |
Aetna Setting Professional Modifier None Typical Low $1.48 Median $2.75 Typical High $2.82 | Professional | None | $1.48 | $2.75 | $2.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.91 Median $2.24 Typical High $2.57 | Professional | None | $1.91 | $2.24 | $2.57 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.70 Median $1.91 Typical High $2.24 | Professional | UE · Used equipment | $1.70 | $1.91 | $2.24 |
CareSource Setting Facility Modifier None Typical Low $2.45 Median $3.39 Typical High $5.50 | Facility | None | $2.45 | $3.39 | $5.50 |
CareSource Setting Professional Modifier None Typical Low $3.80 Median $4.68 Typical High $6.03 | Professional | None | $3.80 | $4.68 | $6.03 |
Cigna Setting Facility Modifier None Typical Low $2.69 Median $3.31 Typical High $5.62 | Facility | None | $2.69 | $3.31 | $5.62 |
Cigna Setting Professional Modifier None Typical Low $2.29 Median $2.88 Typical High $19.95 | Professional | None | $2.29 | $2.88 | $19.95 |
Molina Setting Professional Modifier None Typical Low $2.14 Median $2.69 Typical High $5.37 | Professional | None | $2.14 | $2.69 | $5.37 |
United Setting Professional Modifier None Typical Low $1.26 Median $1.91 Typical High $2.69 | Professional | None | $1.26 | $1.91 | $2.69 |
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 $0.85 Median $1.38 Typical High $1.45 | Professional | 52 · Reduced service | $0.85 | $1.38 | $1.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.30 Median $0.56 Typical High $0.56 | Professional | 53 · Discontinued | $0.30 | $0.56 | $0.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.26 Median $0.42 Typical High $0.43 | Professional | 55 · Aftercare only | $0.26 | $0.42 | $0.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.28 Typical High $0.28 | Professional | 56 · Pre-op care only | $0.15 | $0.28 | $0.28 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.23 Median $0.23 Typical High $0.23 | Professional | RR · Rental | $0.23 | $0.23 | $0.23 |
Where Kentucky sits
The same service costs 2.1 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· 50th of 51
$2.24
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.