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 $60.26 Median $60.26 Typical High $69.18 | Facility | None | $60.26 | $60.26 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $69.18 Typical High $69.18 | Professional | None | $60.26 | $69.18 | $69.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $69.18 Typical High $72.44 | Professional | None | $52.48 | $69.18 | $72.44 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | UE · Used equipment | $51.29 | $51.29 | $51.29 |
CareSource Setting Facility Modifier None Typical Low $70.79 Median $97.72 Typical High $158.49 | Facility | None | $70.79 | $97.72 | $158.49 |
CareSource Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $173.78 | Professional | None | $107.15 | $134.90 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $83.18 Typical High $537.03 | Professional | None | $44.67 | $83.18 | $537.03 |
Molina Setting Professional Modifier None Typical Low $51.29 Median $64.57 Typical High $154.88 | Professional | None | $51.29 | $64.57 | $154.88 |
United Setting Professional Modifier None Typical Low $31.62 Median $48.98 Typical High $70.79 | Professional | None | $31.62 | $48.98 | $70.79 |
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 $30.20 Median $34.67 Typical High $34.67 | Professional | 52 · Reduced service | $30.20 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $13.80 Typical High $13.80 | Professional | 53 · Discontinued | $12.02 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $10.23 Typical High $10.47 | Professional | 55 · Aftercare only | $8.91 | $10.23 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.92 Typical High $6.92 | Professional | 56 · Pre-op care only | $6.03 | $6.92 | $6.92 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | RR · Rental | $6.92 | $6.92 | $6.92 |
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· 27th of 51
$69.18
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.