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 $1.45 Median $1.45 Typical High $1.66 | Facility | None | $1.45 | $1.45 | $1.66 |
Aetna Setting Professional Modifier None Typical Low $1.45 Median $1.58 Typical High $1.66 | Professional | None | $1.45 | $1.58 | $1.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.00 Median $1.26 Typical High $1.78 | Professional | None | $1.00 | $1.26 | $1.78 |
CareSource Setting Facility Modifier None Typical Low $2.63 Median $2.63 Typical High $2.63 | Facility | None | $2.63 | $2.63 | $2.63 |
CareSource Setting Professional Modifier None Typical Low $2.82 Median $3.24 Typical High $4.17 | Professional | None | $2.82 | $3.24 | $4.17 |
Cigna Setting Facility Modifier None Typical Low $3.63 Median $3.63 Typical High $3.63 | Facility | None | $3.63 | $3.63 | $3.63 |
Cigna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $12.88 | Professional | None | $1.32 | $1.32 | $12.88 |
Molina Setting Professional Modifier None Typical Low $1.55 Median $3.72 Typical High $3.72 | Professional | None | $1.55 | $3.72 | $3.72 |
United Setting Professional Modifier None Typical Low $0.87 Median $1.17 Typical High $1.58 | Professional | None | $0.87 | $1.17 | $1.58 |
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 $0.72 Median $0.79 Typical High $0.83 | Professional | 52 · Reduced service | $0.72 | $0.79 | $0.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.28 Median $0.31 Typical High $0.33 | Professional | 53 · Discontinued | $0.28 | $0.31 | $0.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.22 Median $0.24 Typical High $0.25 | Professional | 55 · Aftercare only | $0.22 | $0.24 | $0.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.16 Typical High $0.17 | Professional | 56 · Pre-op care only | $0.14 | $0.16 | $0.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | RR · Rental | $0.12 | $0.12 | $0.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.87 Median $0.89 Typical High $1.26 | Professional | UE · Used equipment | $0.87 | $0.89 | $1.26 |
Where Kentucky sits
The same service costs 2.6 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· 37th of 51
$1.32
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.