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 $1.26 Median $2.75 Typical High $3.16 | Facility | None | $1.26 | $2.75 | $3.16 |
Aetna Setting Professional Modifier None Typical Low $1.35 Median $3.02 Typical High $3.16 | Professional | None | $1.35 | $3.02 | $3.16 |
Ambetter Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.40 Median $2.45 Typical High $3.31 | Professional | None | $2.40 | $2.45 | $3.31 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.24 Median $0.24 Typical High $0.24 | Professional | RR · Rental | $0.24 | $0.24 | $0.24 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.78 Median $1.78 Typical High $2.45 | Professional | UE · Used equipment | $1.78 | $1.78 | $2.45 |
CareSource Setting Facility Modifier None Typical Low $3.24 Median $4.47 Typical High $7.08 | Facility | None | $3.24 | $4.47 | $7.08 |
CareSource Setting Professional Modifier None Typical Low $4.90 Median $6.17 Typical High $7.94 | Professional | None | $4.90 | $6.17 | $7.94 |
Cigna Setting Facility Modifier None Typical Low $2.95 Median $3.16 Typical High $6.92 | Facility | None | $2.95 | $3.16 | $6.92 |
Cigna Setting Professional Modifier None Typical Low $2.51 Median $3.16 Typical High $24.55 | Professional | None | $2.51 | $3.16 | $24.55 |
Molina Setting Professional Modifier None Typical Low $3.02 Median $3.89 Typical High $7.08 | Professional | None | $3.02 | $3.89 | $7.08 |
United Setting Professional Modifier None Typical Low $1.62 Median $2.24 Typical High $3.24 | Professional | None | $1.62 | $2.24 | $3.24 |
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 $0.19 Median $0.47 Typical High $0.47 | Professional | 55 · Aftercare only | $0.19 | $0.47 | $0.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.31 Typical High $0.32 | Professional | 56 · Pre-op care only | $0.22 | $0.31 | $0.32 |
Where Kentucky sits
The same service costs 2.1 times more in Montana than in Colorado. 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· 48th of 51
$2.51
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.