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 $2.29 Median $3.98 Typical High $4.57 | Facility | None | $2.29 | $3.98 | $4.57 |
Aetna Setting Professional Modifier None Typical Low $2.29 Median $4.57 Typical High $6.76 | Professional | None | $2.29 | $4.57 | $6.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Facility | None | $6.76 | $6.76 | $6.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.88 Median $3.80 Typical High $4.57 | Professional | None | $2.88 | $3.80 | $4.57 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $5.75 Median $218.78 Typical High $218.78 | Professional | None | $5.75 | $218.78 | $218.78 |
United Setting Professional Modifier None Typical Low $3.39 Median $5.13 Typical High $7.24 | Professional | None | $3.39 | $5.13 | $7.24 |
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 $0.34 Median $0.69 Typical High $1.00 | Professional | 55 · Aftercare only | $0.34 | $0.69 | $1.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.23 Median $0.46 Typical High $0.68 | Professional | 56 · Pre-op care only | $0.23 | $0.46 | $0.68 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.19 Median $2.88 Typical High $3.24 | Professional | UE · Used equipment | $2.19 | $2.88 | $3.24 |
Where Kentucky sits
The same service costs 83.2 times more in Kansas than in Indiana. 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· 46th of 51
$4.47
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.