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 $0.78 Median $1.41 Typical High $1.62 | Facility | None | $0.78 | $1.41 | $1.62 |
Aetna Setting Professional Modifier None Typical Low $0.78 Median $1.58 Typical High $1.62 | Professional | None | $0.78 | $1.58 | $1.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.26 Median $1.32 Typical High $1.70 | Professional | None | $1.26 | $1.32 | $1.70 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | RR · Rental | $0.13 | $0.13 | $0.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.93 Median $0.93 Typical High $1.32 | Professional | UE · Used equipment | $0.93 | $0.93 | $1.32 |
CareSource Setting Facility Modifier None Typical Low $1.62 Median $2.24 Typical High $3.63 | Facility | None | $1.62 | $2.24 | $3.63 |
CareSource Setting Professional Modifier None Typical Low $2.51 Median $3.16 Typical High $3.98 | Professional | None | $2.51 | $3.16 | $3.98 |
Cigna Setting Facility Modifier None Typical Low $1.51 Median $1.58 Typical High $3.47 | Facility | None | $1.51 | $1.58 | $3.47 |
Cigna Setting Professional Modifier None Typical Low $1.29 Median $1.58 Typical High $12.30 | Professional | None | $1.29 | $1.58 | $12.30 |
Molina Setting Professional Modifier None Typical Low $1.15 Median $1.48 Typical High $3.55 | Professional | None | $1.15 | $1.48 | $3.55 |
United Setting Professional Modifier None Typical Low $0.81 Median $1.12 Typical High $1.66 | Professional | None | $0.81 | $1.12 | $1.66 |
2 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 55 · Aftercare only Typical Low $0.12 Median $0.24 Typical High $0.24 | Professional | 55 · Aftercare only | $0.12 | $0.24 | $0.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.16 Typical High $0.16 | Professional | 56 · Pre-op care only | $0.08 | $0.16 | $0.16 |
Where Kentucky sits
The same service costs 2.1 times more in Idaho than in Connecticut. 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· 40th of 51
$1.32
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.