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 $64.57 Median $104.71 Typical High $107.15 | Facility | None | $64.57 | $104.71 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $104.71 Typical High $120.23 | Professional | None | $64.57 | $104.71 | $120.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $128.82 Median $204.17 Typical High $213.80 | Facility | None | $128.82 | $204.17 | $213.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $102.33 Typical High $131.83 | Professional | None | $91.20 | $102.33 | $131.83 |
CareSource Setting Facility Modifier None Typical Low $131.83 Median $181.97 Typical High $288.40 | Facility | None | $131.83 | $181.97 | $288.40 |
CareSource Setting Professional Modifier None Typical Low $199.53 Median $251.19 Typical High $323.59 | Professional | None | $199.53 | $251.19 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $275.42 | Facility | None | $123.03 | $123.03 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $977.24 | Professional | None | $89.13 | $123.03 | $977.24 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $154.88 | Professional | None | $128.82 | $128.82 | $154.88 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $100.00 | Facility | None | $87.10 | $87.10 | $100.00 |
United Setting Professional Modifier None Typical Low $66.07 Median $91.20 Typical High $131.83 | Professional | None | $66.07 | $91.20 | $131.83 |
6 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 $39.81 Median $52.48 Typical High $60.26 | Professional | 52 · Reduced service | $39.81 | $52.48 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $20.89 Typical High $23.99 | Professional | 53 · Discontinued | $16.22 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $15.85 Typical High $18.20 | Professional | 55 · Aftercare only | $12.02 | $15.85 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.47 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.94 | $10.47 | $12.02 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | RR · Rental | $10.72 | $10.72 | $10.72 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | UE · Used equipment | $79.43 | $79.43 | $79.43 |
Where Kentucky sits
The same service costs 2.5 times more in Hawaii than in Arizona. 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· 41st of 51
$102
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.