How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $14.45 Median $23.99 Typical High $27.54 | Facility | None | $14.45 | $23.99 | $27.54 |
Aetna Setting Professional Modifier None Typical Low $23.99 Median $25.70 Typical High $27.54 | Professional | None | $23.99 | $25.70 | $27.54 |
Ambetter Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.62 Median $19.50 Typical High $29.51 | Professional | None | $18.62 | $19.50 | $29.51 |
CareSource Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
CareSource Setting Professional Modifier None Typical Low $46.77 Median $53.70 Typical High $69.18 | Professional | None | $46.77 | $53.70 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $213.80 | Professional | None | $21.88 | $21.88 | $213.80 |
Molina Setting Professional Modifier None Typical Low $25.70 Median $61.66 Typical High $61.66 | Professional | None | $25.70 | $61.66 | $61.66 |
United Setting Professional Modifier None Typical Low $13.49 Median $15.14 Typical High $15.14 | Professional | None | $13.49 | $15.14 | $15.14 |
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 $12.02 Median $12.88 Typical High $13.80 | Professional | 52 · Reduced service | $12.02 | $12.88 | $13.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $5.25 Typical High $5.50 | Professional | 53 · Discontinued | $4.79 | $5.25 | $5.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $3.89 Typical High $4.17 | Professional | 55 · Aftercare only | $3.55 | $3.89 | $4.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $2.57 Typical High $2.75 | Professional | 56 · Pre-op care only | $2.40 | $2.57 | $2.75 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.91 Median $1.91 Typical High $1.91 | Professional | RR · Rental | $1.91 | $1.91 | $1.91 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $14.45 Median $14.45 Typical High $14.79 | Professional | UE · Used equipment | $14.45 | $14.45 | $14.79 |
Where Kentucky sits
The same service costs 3.2 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· 40th of 51
$20.42
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.