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 $151.36 Median $223.87 Typical High $302.00 | Facility | None | $151.36 | $223.87 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $251.19 Typical High $302.00 | Professional | None | $134.90 | $251.19 | $302.00 |
Ambetter Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $380.19 | Professional | None | $323.59 | $323.59 | $380.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $269.15 Median $426.58 Typical High $446.68 | Facility | None | $269.15 | $426.58 | $446.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $245.47 Typical High $281.84 | Professional | None | $194.98 | $245.47 | $281.84 |
CareSource Setting Facility Modifier None Typical Low $275.42 Median $380.19 Typical High $616.60 | Facility | None | $275.42 | $380.19 | $616.60 |
CareSource Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $676.08 | Professional | None | $416.87 | $524.81 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $645.65 | Facility | None | $316.23 | $316.23 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $316.23 Typical High $2,344.23 | Professional | None | $229.09 | $316.23 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $323.59 | Professional | None | $269.15 | $269.15 | $323.59 |
United Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $269.15 | Facility | None | $245.47 | $245.47 | $269.15 |
United Setting Professional Modifier None Typical Low $141.25 Median $208.93 Typical High $316.23 | Professional | None | $141.25 | $208.93 | $316.23 |
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 $93.33 Median $144.54 Typical High $151.36 | Professional | 52 · Reduced service | $93.33 | $144.54 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $58.88 Typical High $60.26 | Professional | 53 · Discontinued | $37.15 | $58.88 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $43.65 Typical High $45.71 | Professional | 55 · Aftercare only | $28.18 | $43.65 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $29.51 Typical High $30.20 | Professional | 56 · Pre-op care only | $18.62 | $29.51 | $30.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | RR · Rental | $25.12 | $25.12 | $25.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $190.55 Median $190.55 Typical High $199.53 | Professional | UE · Used equipment | $190.55 | $190.55 | $199.53 |
Where Kentucky sits
The same service costs 2.6 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· 40th of 51
$245
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.