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 $1.02 Median $2.14 Typical High $2.40 | Facility | None | $1.02 | $2.14 | $2.40 |
Aetna Setting Professional Modifier None Typical Low $1.05 Median $2.14 Typical High $2.40 | Professional | None | $1.05 | $2.14 | $2.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.91 Median $2.00 Typical High $2.57 | Professional | None | $1.91 | $2.00 | $2.57 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.19 Median $0.19 Typical High $0.19 | Professional | RR · Rental | $0.19 | $0.19 | $0.19 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.41 Median $1.41 Typical High $2.00 | Professional | UE · Used equipment | $1.41 | $1.41 | $2.00 |
CareSource Setting Facility Modifier None Typical Low $2.82 Median $3.80 Typical High $5.50 | Facility | None | $2.82 | $3.80 | $5.50 |
CareSource Setting Professional Modifier None Typical Low $3.80 Median $4.17 Typical High $5.62 | Professional | None | $3.80 | $4.17 | $5.62 |
Cigna Setting Facility Modifier None Typical Low $2.29 Median $2.40 Typical High $5.25 | Facility | None | $2.29 | $2.40 | $5.25 |
Cigna Setting Professional Modifier None Typical Low $1.95 Median $2.40 Typical High $18.62 | Professional | None | $1.95 | $2.40 | $18.62 |
Molina Setting Professional Modifier None Typical Low $1.86 Median $2.40 Typical High $5.37 | Professional | None | $1.86 | $2.40 | $5.37 |
United Setting Professional Modifier None Typical Low $1.23 Median $1.70 Typical High $2.51 | Professional | None | $1.23 | $1.70 | $2.51 |
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 $0.15 Median $0.36 Typical High $0.36 | Professional | 55 · Aftercare only | $0.15 | $0.36 | $0.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.24 Typical High $0.24 | Professional | 56 · Pre-op care only | $0.10 | $0.24 | $0.24 |
Where Kentucky sits
The same service costs 2.1 times more in Idaho 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· 42nd of 51
$2.00
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.