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 $0.68 Median $1.12 Typical High $1.17 | Facility | None | $0.68 | $1.12 | $1.17 |
Aetna Setting Professional Modifier None Typical Low $0.87 Median $1.17 Typical High $1.20 | Professional | None | $0.87 | $1.17 | $1.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.35 | Professional | None | $1.00 | $1.00 | $1.35 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.74 Median $0.79 Typical High $1.05 | Professional | UE · Used equipment | $0.74 | $0.79 | $1.05 |
CareSource Setting Facility Modifier None Typical Low $1.32 Median $1.82 Typical High $2.88 | Facility | None | $1.32 | $1.82 | $2.88 |
CareSource Setting Professional Modifier None Typical Low $2.00 Median $2.51 Typical High $3.24 | Professional | None | $2.00 | $2.51 | $3.24 |
Cigna Setting Facility Modifier None Typical Low $1.20 Median $1.29 Typical High $2.82 | Facility | None | $1.20 | $1.29 | $2.82 |
Cigna Setting Professional Modifier None Typical Low $1.02 Median $1.29 Typical High $9.77 | Professional | None | $1.02 | $1.29 | $9.77 |
Molina Setting Professional Modifier None Typical Low $1.12 Median $1.41 Typical High $2.88 | Professional | None | $1.12 | $1.41 | $2.88 |
United Setting Professional Modifier None Typical Low $0.66 Median $0.91 Typical High $1.32 | Professional | None | $0.66 | $0.91 | $1.32 |
3 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 $0.10 Median $0.18 Typical High $0.18 | Professional | 55 · Aftercare only | $0.10 | $0.18 | $0.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.12 Typical High $0.12 | Professional | 56 · Pre-op care only | $0.07 | $0.12 | $0.12 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.10 Median $0.10 Typical High $0.10 | Professional | RR · Rental | $0.10 | $0.10 | $0.10 |
Where Kentucky sits
The same service costs 2.1 times more in Kansas than in Kentucky. 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· 51st of 51
$1.00
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.