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 $5.25 Median $8.91 Typical High $10.00 | Facility | None | $5.25 | $8.91 | $10.00 |
Aetna Setting Professional Modifier None Typical Low $6.92 Median $10.00 Typical High $10.00 | Professional | None | $6.92 | $10.00 | $10.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.94 Median $8.13 Typical High $11.75 | Professional | None | $7.94 | $8.13 | $11.75 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | RR · Rental | $0.79 | $0.79 | $0.79 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | UE · Used equipment | $5.89 | $5.89 | $5.89 |
CareSource Setting Facility Modifier None Typical Low $10.23 Median $14.13 Typical High $22.91 | Facility | None | $10.23 | $14.13 | $22.91 |
CareSource Setting Professional Modifier None Typical Low $15.85 Median $19.95 Typical High $25.12 | Professional | None | $15.85 | $19.95 | $25.12 |
Cigna Setting Facility Modifier None Typical Low $8.13 Median $9.55 Typical High $21.88 | Facility | None | $8.13 | $9.55 | $21.88 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $9.55 Typical High $77.62 | Professional | None | $8.13 | $9.55 | $77.62 |
Molina Setting Professional Modifier None Typical Low $8.91 Median $11.22 Typical High $22.39 | Professional | None | $8.91 | $11.22 | $22.39 |
United Setting Professional Modifier None Typical Low $5.13 Median $7.08 Typical High $10.47 | Professional | None | $5.13 | $7.08 | $10.47 |
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 $1.05 Median $1.51 Typical High $1.51 | Professional | 55 · Aftercare only | $1.05 | $1.51 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.69 Median $1.00 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.69 | $1.00 | $1.00 |
Where Kentucky sits
The same service costs 2.2 times more in Kansas than in Connecticut. 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· 49th of 51
$8.13
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.