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 $0.52 Median $0.52 Typical High $0.62 | Facility | None | $0.52 | $0.52 | $0.62 |
Aetna Setting Professional Modifier None Typical Low $0.52 Median $0.56 Typical High $0.62 | Professional | None | $0.52 | $0.56 | $0.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.35 Median $0.45 Typical High $0.65 | Professional | None | $0.35 | $0.45 | $0.65 |
CareSource Setting Facility Modifier None Typical Low $0.95 Median $0.95 Typical High $0.95 | Facility | None | $0.95 | $0.95 | $0.95 |
CareSource Setting Professional Modifier None Typical Low $1.02 Median $1.20 Typical High $1.51 | Professional | None | $1.02 | $1.20 | $1.51 |
Cigna Setting Facility Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Facility | None | $1.32 | $1.32 | $1.32 |
Cigna Setting Professional Modifier None Typical Low $0.49 Median $0.49 Typical High $4.68 | Professional | None | $0.49 | $0.49 | $4.68 |
Molina Setting Professional Modifier None Typical Low $0.56 Median $1.35 Typical High $1.35 | Professional | None | $0.56 | $1.35 | $1.35 |
United Setting Professional Modifier None Typical Low $0.32 Median $0.42 Typical High $0.56 | Professional | None | $0.32 | $0.42 | $0.56 |
5 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 $0.26 Median $0.28 Typical High $0.31 | Professional | 52 · Reduced service | $0.26 | $0.28 | $0.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.10 Median $0.11 Typical High $0.12 | Professional | 53 · Discontinued | $0.10 | $0.11 | $0.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.09 Typical High $0.09 | Professional | 55 · Aftercare only | $0.08 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.05 | $0.06 | $0.06 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.32 Median $0.34 Typical High $0.45 | Professional | UE · Used equipment | $0.32 | $0.34 | $0.45 |
Where Kentucky sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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
$0.47
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.