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 $18.20 Median $30.20 Typical High $34.67 | Facility | None | $18.20 | $30.20 | $34.67 |
Aetna Setting Professional Modifier None Typical Low $23.99 Median $34.67 Typical High $38.02 | Professional | None | $23.99 | $34.67 | $38.02 |
Ambetter Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $56.23 | Professional | None | $54.95 | $54.95 | $56.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $39.81 | Professional | None | $26.92 | $26.92 | $39.81 |
CareSource Setting Facility Modifier None Typical Low $35.48 Median $48.98 Typical High $77.62 | Facility | None | $35.48 | $48.98 | $77.62 |
CareSource Setting Professional Modifier None Typical Low $53.70 Median $67.61 Typical High $87.10 | Professional | None | $53.70 | $67.61 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $75.86 | Facility | None | $35.48 | $35.48 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $35.48 Typical High $263.03 | Professional | None | $25.70 | $35.48 | $263.03 |
Molina Setting Professional Modifier None Typical Low $36.31 Median $46.77 Typical High $77.62 | Professional | None | $36.31 | $46.77 | $77.62 |
United Setting Professional Modifier None Typical Low $17.78 Median $26.30 Typical High $40.74 | Professional | None | $17.78 | $26.30 | $40.74 |
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 $12.30 Median $16.98 Typical High $17.38 | Professional | 52 · Reduced service | $12.30 | $16.98 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $6.92 Typical High $6.92 | Professional | 53 · Discontinued | $4.90 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $5.13 Typical High $5.25 | Professional | 55 · Aftercare only | $3.72 | $5.13 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $3.47 Typical High $3.47 | Professional | 56 · Pre-op care only | $2.45 | $3.47 | $3.47 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.09 Median $3.09 Typical High $3.31 | Professional | RR · Rental | $3.09 | $3.09 | $3.31 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | UE · Used equipment | $22.91 | $22.91 | $22.91 |
Where Kentucky sits
The same service costs 2.2 times more in Hawaii 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· 44th of 51
$30.20
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.