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 $28.18 Median $30.90 Typical High $45.71 | Facility | None | $28.18 | $30.90 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $30.90 Typical High $45.71 | Professional | None | $26.92 | $30.90 | $45.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $38.02 Median $60.26 Typical High $63.10 | Facility | None | $38.02 | $60.26 | $63.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $63.10 Typical High $74.13 | Professional | None | $53.70 | $63.10 | $74.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.37 Median $5.37 Typical High $5.62 | Professional | RR · Rental | $5.37 | $5.37 | $5.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $40.74 Median $40.74 Typical High $41.69 | Professional | UE · Used equipment | $40.74 | $40.74 | $41.69 |
CareSource Setting Facility Modifier None Typical Low $38.02 Median $52.48 Typical High $85.11 | Facility | None | $38.02 | $52.48 | $85.11 |
CareSource Setting Professional Modifier None Typical Low $58.88 Median $74.13 Typical High $93.33 | Professional | None | $58.88 | $74.13 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $83.18 | Facility | None | $52.48 | $52.48 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $48.98 Typical High $269.15 | Professional | None | $44.67 | $48.98 | $269.15 |
Molina Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $89.13 | Professional | None | $74.13 | $74.13 | $89.13 |
United Setting Professional Modifier None Typical Low $30.90 Median $44.67 Typical High $63.10 | Professional | None | $30.90 | $44.67 | $63.10 |
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 $14.13 Median $15.49 Typical High $22.91 | Professional | 52 · Reduced service | $14.13 | $15.49 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $6.31 Typical High $9.12 | Professional | 53 · Discontinued | $5.62 | $6.31 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $4.68 Typical High $6.92 | Professional | 55 · Aftercare only | $4.17 | $4.68 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $3.16 Typical High $4.57 | Professional | 56 · Pre-op care only | $2.82 | $3.16 | $4.57 |
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· 20th of 51
$53.70
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.