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 $0.98 Median $0.98 Typical High $1.12 | Facility | None | $0.98 | $0.98 | $1.12 |
Aetna Setting Professional Modifier None Typical Low $0.95 Median $1.05 Typical High $1.12 | Professional | None | $0.95 | $1.05 | $1.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.76 Median $0.85 Typical High $1.20 | Professional | None | $0.76 | $0.85 | $1.20 |
CareSource Setting Facility Modifier None Typical Low $1.74 Median $1.74 Typical High $1.74 | Facility | None | $1.74 | $1.74 | $1.74 |
CareSource Setting Professional Modifier None Typical Low $1.86 Median $2.19 Typical High $2.82 | Professional | None | $1.86 | $2.19 | $2.82 |
Cigna Setting Facility Modifier None Typical Low $2.45 Median $2.45 Typical High $2.45 | Facility | None | $2.45 | $2.45 | $2.45 |
Cigna Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $8.71 | Professional | None | $0.89 | $0.89 | $8.71 |
Molina Setting Professional Modifier None Typical Low $1.07 Median $2.51 Typical High $2.51 | Professional | None | $1.07 | $2.51 | $2.51 |
United Setting Professional Modifier None Typical Low $0.59 Median $0.79 Typical High $1.10 | Professional | None | $0.59 | $0.79 | $1.10 |
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 $0.48 Median $0.52 Typical High $0.56 | Professional | 52 · Reduced service | $0.48 | $0.52 | $0.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.19 Median $0.21 Typical High $0.22 | Professional | 53 · Discontinued | $0.19 | $0.21 | $0.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.14 Median $0.16 Typical High $0.17 | Professional | 55 · Aftercare only | $0.14 | $0.16 | $0.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.11 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.10 | $0.11 | $0.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.59 Median $0.59 Typical High $0.79 | Professional | UE · Used equipment | $0.59 | $0.59 | $0.79 |
Where Kentucky sits
The same service costs 2.5 times more in Idaho 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· 46th of 51
$0.89
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.