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 $0.16 Median $0.16 Typical High $0.18 | Facility | None | $0.16 | $0.16 | $0.18 |
Aetna Setting Professional Modifier None Typical Low $0.16 Median $0.18 Typical High $0.23 | Professional | None | $0.16 | $0.18 | $0.23 |
Ambetter Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $19.95 | Professional | None | $10.96 | $10.96 | $19.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.15 Median $0.17 Typical High $0.22 | Professional | None | $0.15 | $0.17 | $0.22 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.13 Median $0.14 Typical High $0.18 | Professional | UE · Used equipment | $0.13 | $0.14 | $0.18 |
CareSource Setting Facility Modifier None Typical Low $0.20 Median $0.28 Typical High $0.44 | Facility | None | $0.20 | $0.28 | $0.44 |
CareSource Setting Professional Modifier None Typical Low $0.28 Median $0.35 Typical High $0.46 | Professional | None | $0.28 | $0.35 | $0.46 |
Cigna Setting Facility Modifier None Typical Low $0.19 Median $0.20 Typical High $85.11 | Facility | None | $0.19 | $0.20 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $0.17 Median $0.20 Typical High $0.89 | Professional | None | $0.17 | $0.20 | $0.89 |
Molina Setting Professional Modifier None Typical Low $0.16 Median $0.21 Typical High $0.43 | Professional | None | $0.16 | $0.21 | $0.43 |
United Setting Professional Modifier None Typical Low $0.11 Median $0.15 Typical High $0.20 | Professional | None | $0.11 | $0.15 | $0.20 |
4 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 |
|---|---|---|---|---|---|
Anthem BCBS Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.24 Median $0.31 Typical High $0.56 | Professional | AU · Urologic/ostomy supply | $0.24 | $0.31 | $0.56 |
Anthem BCBS Setting Professional Modifier AV · With prosthetic/orthotic Typical Low $0.27 Median $0.33 Typical High $0.62 | Professional | AV · With prosthetic/orthotic | $0.27 | $0.33 | $0.62 |
Cigna Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.24 Median $0.25 Typical High $0.25 | Professional | AU · Urologic/ostomy supply | $0.24 | $0.25 | $0.25 |
Cigna Setting Professional Modifier AV · With prosthetic/orthotic Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | AV · With prosthetic/orthotic | $0.26 | $0.26 | $0.26 |
Where Kentucky sits
The same service costs 2.7 times more in Arkansas than in Utah. 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· 50th of 51
$0.17
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.