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 $3.89 Median $6.92 Typical High $7.94 | Facility | None | $3.89 | $6.92 | $7.94 |
Aetna Setting Professional Modifier None Typical Low $3.89 Median $7.94 Typical High $11.48 | Professional | None | $3.89 | $7.94 | $11.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Facility | None | $11.48 | $11.48 | $11.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.17 Median $5.89 Typical High $7.94 | Professional | None | $4.17 | $5.89 | $7.94 |
CareSource Setting Facility Modifier None Typical Low $10.00 Median $13.49 Typical High $15.85 | Facility | None | $10.00 | $13.49 | $15.85 |
CareSource Setting Professional Modifier None Typical Low $10.00 Median $12.02 Typical High $16.22 | Professional | None | $10.00 | $12.02 | $16.22 |
Cigna Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Facility | None | $16.22 | $16.22 | $16.22 |
Cigna Setting Professional Modifier None Typical Low $5.13 Median $57.54 Typical High $57.54 | Professional | None | $5.13 | $57.54 | $57.54 |
United Setting Professional Modifier None Typical Low $5.75 Median $8.71 Typical High $10.96 | Professional | None | $5.75 | $8.71 | $10.96 |
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 $0.59 Median $1.17 Typical High $1.74 | Professional | 55 · Aftercare only | $0.59 | $1.17 | $1.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.39 Median $0.79 Typical High $1.15 | Professional | 56 · Pre-op care only | $0.39 | $0.79 | $1.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.09 Median $3.09 Typical High $7.24 | Professional | UE · Used equipment | $3.09 | $3.09 | $7.24 |
Where Kentucky sits
The same service costs 4.6 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· 40th of 51
$7.59
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.