How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $0.49 Median $0.49 Typical High $0.49 | Facility | None | $0.49 | $0.49 | $0.49 |
Aetna Setting Professional Modifier None Typical Low $0.49 Median $0.49 Typical High $0.49 | Professional | None | $0.49 | $0.49 | $0.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.52 Median $0.58 Typical High $1.20 | Facility | None | $0.52 | $0.58 | $1.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.49 Median $0.49 Typical High $0.52 | Professional | None | $0.49 | $0.49 | $0.52 |
CareSource Setting Facility Modifier None Typical Low $0.63 Median $0.63 Typical High $1.00 | Facility | None | $0.63 | $0.63 | $1.00 |
CareSource Setting Professional Modifier None Typical Low $0.63 Median $0.66 Typical High $0.91 | Professional | None | $0.63 | $0.66 | $0.91 |
Cigna Setting Facility Modifier None Typical Low $0.62 Median $0.76 Typical High $1.70 | Facility | None | $0.62 | $0.76 | $1.70 |
Cigna Setting Professional Modifier None Typical Low $0.49 Median $0.49 Typical High $2.19 | Professional | None | $0.49 | $0.49 | $2.19 |
Molina Setting Professional Modifier None Typical Low $0.62 Median $0.62 Typical High $0.79 | Professional | None | $0.62 | $0.62 | $0.79 |
United Setting Professional Modifier None Typical Low $0.52 Median $0.55 Typical High $0.58 | Professional | None | $0.52 | $0.55 | $0.58 |
4 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 52 · Reduced service Typical Low $0.25 Median $0.25 Typical High $0.25 | Professional | 52 · Reduced service | $0.25 | $0.25 | $0.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.10 Median $0.10 Typical High $0.10 | Professional | 53 · Discontinued | $0.10 | $0.10 | $0.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 55 · Aftercare only | $0.07 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.05 |
Where Kentucky sits
The same service costs 2.6 times more in Wyoming than in Illinois. 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· 37th of 51
$0.49
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.