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 $1.91 Median $3.63 Typical High $4.17 | Facility | None | $1.91 | $3.63 | $4.17 |
Aetna Setting Professional Modifier None Typical Low $2.82 Median $4.17 Typical High $4.17 | Professional | None | $2.82 | $4.17 | $4.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.39 Median $5.75 Typical High $22.91 | Professional | None | $3.39 | $5.75 | $22.91 |
CareSource Setting Facility Modifier None Typical Low $4.90 Median $6.46 Typical High $9.55 | Facility | None | $4.90 | $6.46 | $9.55 |
CareSource Setting Professional Modifier None Typical Low $6.46 Median $7.24 Typical High $9.77 | Professional | None | $6.46 | $7.24 | $9.77 |
Cigna Setting Facility Modifier None Typical Low $3.89 Median $4.17 Typical High $9.12 | Facility | None | $3.89 | $4.17 | $9.12 |
Cigna Setting Professional Modifier None Typical Low $3.31 Median $4.17 Typical High $32.36 | Professional | None | $3.31 | $4.17 | $32.36 |
Molina Setting Professional Modifier None Typical Low $4.68 Median $5.89 Typical High $9.33 | Professional | None | $4.68 | $5.89 | $9.33 |
United Setting Professional Modifier None Typical Low $2.14 Median $3.02 Typical High $4.27 | Professional | None | $2.14 | $3.02 | $4.27 |
6 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 $1.45 Median $2.09 Typical High $2.09 | Professional | 52 · Reduced service | $1.45 | $2.09 | $2.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.56 Median $0.83 Typical High $0.83 | Professional | 53 · Discontinued | $0.56 | $0.83 | $0.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.43 Median $0.62 Typical High $0.63 | Professional | 55 · Aftercare only | $0.43 | $0.62 | $0.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.40 Typical High $0.42 | Professional | 56 · Pre-op care only | $0.19 | $0.40 | $0.42 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.32 Median $0.32 Typical High $0.32 | Professional | RR · Rental | $0.32 | $0.32 | $0.32 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.40 Median $2.40 Typical High $2.40 | Professional | UE · Used equipment | $2.40 | $2.40 | $2.40 |
Where Kentucky sits
The same service costs 2.1 times more in Montana than in New Jersey. 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· 24th of 51
$4.47
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.