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 $7.76 Median $8.13 Typical High $9.33 | Facility | None | $7.76 | $8.13 | $9.33 |
Aetna Setting Professional Modifier None Typical Low $7.76 Median $9.33 Typical High $13.80 | Professional | None | $7.76 | $9.33 | $13.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Facility | None | $13.80 | $13.80 | $13.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.47 Median $10.96 Typical High $15.49 | Professional | None | $10.47 | $10.96 | $15.49 |
CareSource Setting Facility Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Facility | None | $9.33 | $9.33 | $9.33 |
CareSource Setting Professional Modifier None Typical Low $9.33 Median $13.80 Typical High $21.88 | Professional | None | $9.33 | $13.80 | $21.88 |
Cigna Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Facility | None | $19.95 | $19.95 | $19.95 |
Cigna Setting Professional Modifier None Typical Low $14.45 Median $69.18 Typical High $69.18 | Professional | None | $14.45 | $69.18 | $69.18 |
United Setting Professional Modifier None Typical Low $7.59 Median $16.60 Typical High $22.39 | Professional | None | $7.59 | $16.60 | $22.39 |
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 $1.17 Median $1.41 Typical High $2.04 | Professional | 55 · Aftercare only | $1.17 | $1.41 | $2.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.78 Median $0.93 Typical High $1.38 | Professional | 56 · Pre-op care only | $0.78 | $0.93 | $1.38 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.07 Median $1.07 Typical High $1.10 | Professional | RR · Rental | $1.07 | $1.07 | $1.10 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7.94 Median $7.94 Typical High $8.32 | Professional | UE · Used equipment | $7.94 | $7.94 | $8.32 |
Where Kentucky sits
The same service costs 3.5 times more in Florida than in Alabama. 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· 43rd of 51
$11.75
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.