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 $1.38 Median $1.38 Typical High $1.58 | Facility | None | $1.38 | $1.38 | $1.58 |
Aetna Setting Professional Modifier None Typical Low $1.35 Median $1.48 Typical High $1.58 | Professional | None | $1.35 | $1.48 | $1.58 |
Ambetter Setting Professional Modifier None Typical Low $1.58 Median $2.29 Typical High $2.95 | Professional | None | $1.58 | $2.29 | $2.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.91 Median $1.17 Typical High $1.66 | Professional | None | $0.91 | $1.17 | $1.66 |
CareSource Setting Facility Modifier None Typical Low $2.45 Median $2.69 Typical High $3.47 | Facility | None | $2.45 | $2.69 | $3.47 |
CareSource Setting Professional Modifier None Typical Low $2.45 Median $2.63 Typical High $3.47 | Professional | None | $2.45 | $2.63 | $3.47 |
Cigna Setting Facility Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Facility | None | $3.39 | $3.39 | $3.39 |
Cigna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $12.02 | Professional | None | $1.26 | $1.26 | $12.02 |
Molina Setting Professional Modifier None Typical Low $1.45 Median $3.47 Typical High $3.47 | Professional | None | $1.45 | $3.47 | $3.47 |
United Setting Professional Modifier None Typical Low $0.81 Median $1.10 Typical High $1.48 | Professional | None | $0.81 | $1.10 | $1.48 |
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 $0.68 Median $0.74 Typical High $0.79 | Professional | 52 · Reduced service | $0.68 | $0.74 | $0.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.27 Median $0.28 Typical High $0.31 | Professional | 53 · Discontinued | $0.27 | $0.28 | $0.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.20 Median $0.22 Typical High $0.24 | Professional | 55 · Aftercare only | $0.20 | $0.22 | $0.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.15 Typical High $0.16 | Professional | 56 · Pre-op care only | $0.14 | $0.15 | $0.16 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | RR · Rental | $0.11 | $0.11 | $0.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.81 Median $0.89 Typical High $1.29 | Professional | UE · Used equipment | $0.81 | $0.89 | $1.29 |
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· 46th of 51
$1.23
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.