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 $134.90 Median $239.88 Typical High $275.42 | Facility | None | $134.90 | $239.88 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $275.42 Typical High $407.38 | Professional | None | $134.90 | $275.42 | $407.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $177.83 Median $204.17 Typical High $275.42 | Professional | None | $177.83 | $204.17 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $295.12 Median $467.74 Typical High $549.54 | Facility | None | $295.12 | $467.74 | $549.54 |
CareSource Setting Professional Modifier None Typical Low $346.74 Median $407.38 Typical High $562.34 | Professional | None | $346.74 | $407.38 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $1,995.26 Typical High $1,995.26 | Professional | None | $169.82 | $1,995.26 | $1,995.26 |
United Setting Professional Modifier None Typical Low $204.17 Median $302.00 Typical High $380.19 | Professional | None | $204.17 | $302.00 | $380.19 |
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 $20.42 Median $41.69 Typical High $60.26 | Professional | 55 · Aftercare only | $20.42 | $41.69 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $27.54 Typical High $40.74 | Professional | 56 · Pre-op care only | $13.49 | $27.54 | $40.74 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $134.90 Median $134.90 Typical High $251.19 | Professional | UE · Used equipment | $134.90 | $134.90 | $251.19 |
Where Kentucky sits
The same service costs 3.2 times more in Iowa than in New York. 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
$269
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.