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 $147.91 Median $165.96 Typical High $239.88 | Facility | None | $147.91 | $165.96 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $165.96 Typical High $275.42 | Professional | None | $141.25 | $165.96 | $275.42 |
Ambetter Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $331.13 | Professional | None | $309.03 | $309.03 | $331.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $199.53 Median $316.23 Typical High $338.84 | Facility | None | $199.53 | $316.23 | $338.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $331.13 Typical High $389.05 | Professional | None | $281.84 | $331.13 | $389.05 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $28.18 Median $28.18 Typical High $29.51 | Professional | RR · Rental | $28.18 | $28.18 | $29.51 |
CareSource Setting Facility Modifier None Typical Low $204.17 Median $281.84 Typical High $446.68 | Facility | None | $204.17 | $281.84 | $446.68 |
CareSource Setting Professional Modifier None Typical Low $309.03 Median $389.05 Typical High $501.19 | Professional | None | $309.03 | $389.05 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $436.52 | Facility | None | $302.00 | $302.00 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $257.04 Typical High $1,445.44 | Professional | None | $218.78 | $257.04 | $1,445.44 |
Cigna Setting Professional Modifier RR · Rental Typical Low $25.70 Median $25.70 Typical High $30.20 | Professional | RR · Rental | $25.70 | $25.70 | $30.20 |
Molina Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $467.74 | Professional | None | $389.05 | $389.05 | $467.74 |
United Setting Professional Modifier None Typical Low $165.96 Median $234.42 Typical High $331.13 | Professional | None | $165.96 | $234.42 | $331.13 |
5 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 $74.13 Median $83.18 Typical High $120.23 | Professional | 52 · Reduced service | $74.13 | $83.18 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $33.11 Typical High $48.98 | Professional | 53 · Discontinued | $29.51 | $33.11 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $24.55 Typical High $36.31 | Professional | 55 · Aftercare only | $22.39 | $24.55 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $16.60 Typical High $23.99 | Professional | 56 · Pre-op care only | $14.79 | $16.60 | $23.99 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $213.80 Median $213.80 Typical High $223.87 | Professional | UE · Used equipment | $213.80 | $213.80 | $223.87 |
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· 16th of 51
$288
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.