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 $10.96 Median $17.78 Typical High $17.78 | Facility | None | $10.96 | $17.78 | $17.78 |
Aetna Setting Professional Modifier None Typical Low $10.96 Median $17.78 Typical High $23.99 | Professional | None | $10.96 | $17.78 | $23.99 |
Ambetter Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $28.84 | Professional | None | $24.55 | $24.55 | $28.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $21.38 Median $34.67 Typical High $36.31 | Facility | None | $21.38 | $34.67 | $36.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $15.49 Median $18.20 Typical High $23.44 | Professional | None | $15.49 | $18.20 | $23.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | RR · Rental | $1.82 | $1.82 | $1.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $11.75 Median $13.49 Typical High $13.49 | Professional | UE · Used equipment | $11.75 | $13.49 | $13.49 |
CareSource Setting Facility Modifier None Typical Low $21.88 Median $30.20 Typical High $48.98 | Facility | None | $21.88 | $30.20 | $48.98 |
CareSource Setting Professional Modifier None Typical Low $33.88 Median $42.66 Typical High $53.70 | Professional | None | $33.88 | $42.66 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $22.39 Median $22.39 Typical High $46.77 | Facility | None | $22.39 | $22.39 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $22.39 Typical High $169.82 | Professional | None | $16.22 | $22.39 | $169.82 |
Molina Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $25.70 | Professional | None | $21.38 | $21.38 | $25.70 |
United Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $28.18 | Facility | None | $19.95 | $19.95 | $28.18 |
United Setting Professional Modifier None Typical Low $11.22 Median $15.14 Typical High $22.39 | Professional | None | $11.22 | $15.14 | $22.39 |
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 $6.46 Median $8.91 Typical High $11.75 | Professional | 52 · Reduced service | $6.46 | $8.91 | $11.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $3.55 Typical High $4.79 | Professional | 53 · Discontinued | $2.63 | $3.55 | $4.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $2.69 Typical High $3.55 | Professional | 55 · Aftercare only | $1.95 | $2.69 | $3.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $1.78 Typical High $2.34 | Professional | 56 · Pre-op care only | $1.32 | $1.78 | $2.34 |
Where Kentucky sits
The same service costs 3.7 times more in Hawaii than in Florida. 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· 36th of 51
$17.78
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.