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 $9.55 Median $9.55 Typical High $17.78 | Facility | None | $9.55 | $9.55 | $17.78 |
Aetna Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $10.23 Median $11.22 Typical High $14.45 | Facility | None | $10.23 | $11.22 | $14.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.13 Median $9.55 Typical High $10.23 | Professional | None | $8.13 | $9.55 | $10.23 |
CareSource Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $13.18 | Facility | None | $8.13 | $8.13 | $13.18 |
CareSource Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $9.33 | Professional | None | $8.13 | $8.13 | $9.33 |
Cigna Setting Facility Modifier None Typical Low $13.49 Median $34.67 Typical High $85.11 | Facility | None | $13.49 | $34.67 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $75.86 | Professional | None | $9.55 | $9.55 | $75.86 |
Molina Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $10.72 | Professional | None | $8.13 | $8.13 | $10.72 |
United Setting Professional Modifier None Typical Low $8.13 Median $8.51 Typical High $9.33 | Professional | None | $8.13 | $8.51 | $9.33 |
5 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 $4.79 Median $4.79 Typical High $4.79 | Professional | 52 · Reduced service | $4.79 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.91 Median $1.91 Typical High $1.91 | Professional | 53 · Discontinued | $1.91 | $1.91 | $1.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.45 Median $1.45 Typical High $1.45 | Professional | 55 · Aftercare only | $1.45 | $1.45 | $1.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $0.95 Typical High $0.95 | Professional | 56 · Pre-op care only | $0.95 | $0.95 | $0.95 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $8.13 Median $9.55 Typical High $12.59 | Professional | JZ · No drug discarded | $8.13 | $9.55 | $12.59 |
Where Kentucky sits
The same service costs 1.7 times more in Wyoming than in North Carolina. 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· 26th of 51
$9.55
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.