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 $3.80 Median $6.61 Typical High $7.59 | Facility | None | $3.80 | $6.61 | $7.59 |
Aetna Setting Professional Modifier None Typical Low $3.80 Median $7.59 Typical High $11.22 | Professional | None | $3.80 | $7.59 | $11.22 |
Anthem BCBS Setting Facility Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Facility | None | $11.22 | $11.22 | $11.22 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.98 Median $7.41 Typical High $7.59 | Professional | None | $3.98 | $7.41 | $7.59 |
CareSource Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | None | $12.30 | $12.30 | $12.30 |
Cigna Setting Facility Modifier None Typical Low $15.49 Median $15.49 Typical High $15.49 | Facility | None | $15.49 | $15.49 | $15.49 |
Cigna Setting Professional Modifier None Typical Low $5.13 Median $54.95 Typical High $54.95 | Professional | None | $5.13 | $54.95 | $54.95 |
United Setting Professional Modifier None Typical Low $5.62 Median $8.51 Typical High $10.47 | Professional | None | $5.62 | $8.51 | $10.47 |
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 $0.56 Median $1.12 Typical High $1.70 | Professional | 55 · Aftercare only | $0.56 | $1.12 | $1.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.38 Median $0.76 Typical High $1.12 | Professional | 56 · Pre-op care only | $0.38 | $0.76 | $1.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.02 Median $3.98 Typical High $4.37 | Professional | UE · Used equipment | $3.02 | $3.98 | $4.37 |
Where Kentucky sits
The same service costs 4.7 times more in Florida 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· 43rd of 51
$7.41
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.