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 $2.29 Median $2.63 Typical High $3.09 | Facility | None | $2.29 | $2.63 | $3.09 |
Aetna Setting Professional Modifier None Typical Low $2.29 Median $2.63 Typical High $3.80 | Professional | None | $2.29 | $2.63 | $3.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.80 Median $3.80 Typical High $3.80 | Facility | None | $3.80 | $3.80 | $3.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.89 Median $4.17 Typical High $5.89 | Professional | None | $3.89 | $4.17 | $5.89 |
CareSource Setting Facility Modifier None Typical Low $2.63 Median $4.17 Typical High $5.01 | Facility | None | $2.63 | $4.17 | $5.01 |
CareSource Setting Professional Modifier None Typical Low $2.82 Median $3.72 Typical High $5.13 | Professional | None | $2.82 | $3.72 | $5.13 |
Cigna Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Facility | None | $7.59 | $7.59 | $7.59 |
Cigna Setting Professional Modifier None Typical Low $1.62 Median $19.50 Typical High $19.50 | Professional | None | $1.62 | $19.50 | $19.50 |
United Setting Professional Modifier None Typical Low $2.34 Median $6.17 Typical High $7.59 | Professional | None | $2.34 | $6.17 | $7.59 |
4 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 55 · Aftercare only Typical Low $0.34 Median $0.39 Typical High $0.58 | Professional | 55 · Aftercare only | $0.34 | $0.39 | $0.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.23 Median $0.26 Typical High $0.38 | Professional | 56 · Pre-op care only | $0.23 | $0.26 | $0.38 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.32 Median $0.32 Typical High $0.32 | Professional | RR · Rental | $0.32 | $0.32 | $0.32 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.40 Median $3.02 Typical High $3.31 | Professional | UE · Used equipment | $2.40 | $3.02 | $3.31 |
Where Kentucky sits
The same service costs 5.2 times more in Kansas than in Delaware. 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
$4.17
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.