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 $125.89 Median $138.04 Typical High $204.17 | Facility | None | $125.89 | $138.04 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $138.04 Typical High $204.17 | Professional | None | $125.89 | $138.04 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $165.96 Median $269.15 Typical High $281.84 | Facility | None | $165.96 | $269.15 | $281.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $281.84 Typical High $331.13 | Professional | None | $239.88 | $281.84 | $331.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $23.99 Median $23.99 Typical High $26.92 | Professional | RR · Rental | $23.99 | $23.99 | $26.92 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $177.83 Median $177.83 Typical High $199.53 | Professional | UE · Used equipment | $177.83 | $177.83 | $199.53 |
CareSource Setting Facility Modifier None Typical Low $169.82 Median $234.42 Typical High $380.19 | Facility | None | $169.82 | $234.42 | $380.19 |
CareSource Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $416.87 | Professional | None | $263.03 | $331.13 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $363.08 | Facility | None | $275.42 | $275.42 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $213.80 Typical High $1,202.26 | Professional | None | $204.17 | $213.80 | $1,202.26 |
Molina Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $398.11 | Professional | None | $331.13 | $331.13 | $398.11 |
United Setting Professional Modifier None Typical Low $138.04 Median $199.53 Typical High $275.42 | Professional | None | $138.04 | $199.53 | $275.42 |
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 $61.66 Median $69.18 Typical High $102.33 | Professional | 52 · Reduced service | $61.66 | $69.18 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $27.54 Typical High $40.74 | Professional | 53 · Discontinued | $25.12 | $27.54 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $20.89 Typical High $30.90 | Professional | 55 · Aftercare only | $18.62 | $20.89 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $13.80 Typical High $20.42 | Professional | 56 · Pre-op care only | $12.59 | $13.80 | $20.42 |
Where Kentucky sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 15th of 51
$240
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.