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 $28.18 Median $48.98 Typical High $56.23 | Facility | None | $28.18 | $48.98 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $56.23 Typical High $83.18 | Professional | None | $28.18 | $56.23 | $83.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $35.48 Median $42.66 Typical High $56.23 | Professional | None | $35.48 | $42.66 | $56.23 |
CareSource Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $91.20 | Professional | None | $70.79 | $70.79 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $0.09 Median $407.38 Typical High $407.38 | Professional | None | $0.09 | $407.38 | $407.38 |
United Setting Professional Modifier None Typical Low $41.69 Median $63.10 Typical High $89.13 | Professional | None | $41.69 | $63.10 | $89.13 |
3 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 $4.17 Median $8.51 Typical High $12.59 | Professional | 55 · Aftercare only | $4.17 | $8.51 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $5.62 Typical High $8.32 | Professional | 56 · Pre-op care only | $2.82 | $5.62 | $8.32 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $26.92 Median $26.92 Typical High $52.48 | Professional | UE · Used equipment | $26.92 | $26.92 | $52.48 |
Where Kentucky sits
The same service costs 5.5 times more in Iowa than in Kansas. 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· 39th of 51
$54.95
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.