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 $12.30 Median $21.38 Typical High $24.55 | Facility | None | $12.30 | $21.38 | $24.55 |
Aetna Setting Professional Modifier None Typical Low $12.30 Median $24.55 Typical High $36.31 | Professional | None | $12.30 | $24.55 | $36.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $15.85 Median $18.62 Typical High $24.55 | Professional | None | $15.85 | $18.62 | $24.55 |
CareSource Setting Facility Modifier None Typical Low $26.30 Median $41.69 Typical High $48.98 | Facility | None | $26.30 | $41.69 | $48.98 |
CareSource Setting Professional Modifier None Typical Low $30.90 Median $37.15 Typical High $50.12 | Professional | None | $30.90 | $37.15 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $177.83 Typical High $177.83 | Professional | None | $21.38 | $177.83 | $177.83 |
United Setting Professional Modifier None Typical Low $18.20 Median $27.54 Typical High $34.67 | Professional | None | $18.20 | $27.54 | $34.67 |
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 $1.82 Median $3.72 Typical High $5.50 | Professional | 55 · Aftercare only | $1.82 | $3.72 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.23 Median $2.45 Typical High $3.63 | Professional | 56 · Pre-op care only | $1.23 | $2.45 | $3.63 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $12.02 Median $12.02 Typical High $12.88 | Professional | UE · Used equipment | $12.02 | $12.02 | $12.88 |
Where Kentucky sits
The same service costs 3.5 times more in Montana 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
$23.99
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.