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 $177.83 Median $199.53 Typical High $281.84 | Facility | None | $177.83 | $199.53 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $199.53 Typical High $281.84 | Professional | None | $177.83 | $199.53 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $239.88 Median $389.05 Typical High $407.38 | Facility | None | $239.88 | $389.05 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $457.09 | Professional | None | $331.13 | $389.05 | $457.09 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | RR · Rental | $33.11 | $33.11 | $33.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | UE · Used equipment | $245.47 | $245.47 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $245.47 Median $338.84 Typical High $549.54 | Facility | None | $245.47 | $338.84 | $549.54 |
CareSource Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $602.56 | Professional | None | $371.54 | $467.74 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $524.81 | Facility | None | $380.19 | $380.19 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $309.03 Typical High $1,737.80 | Professional | None | $281.84 | $309.03 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $549.54 | Professional | None | $457.09 | $457.09 | $549.54 |
United Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $380.19 | Professional | None | $190.55 | $275.42 | $380.19 |
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 $89.13 Median $100.00 Typical High $141.25 | Professional | 52 · Reduced service | $89.13 | $100.00 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $39.81 Typical High $56.23 | Professional | 53 · Discontinued | $35.48 | $39.81 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $29.51 Typical High $42.66 | Professional | 55 · Aftercare only | $26.92 | $29.51 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $19.95 Typical High $28.18 | Professional | 56 · Pre-op care only | $17.78 | $19.95 | $28.18 |
Where Kentucky sits
The same service costs 3.0 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· 16th of 51
$331
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.