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 $102.33 Median $114.82 Typical High $169.82 | Facility | None | $102.33 | $114.82 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $114.82 Typical High $169.82 | Professional | None | $102.33 | $114.82 | $169.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $138.04 Median $223.87 Typical High $234.42 | Facility | None | $138.04 | $223.87 | $234.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $229.09 Typical High $269.15 | Professional | None | $194.98 | $229.09 | $269.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | RR · Rental | $19.50 | $19.50 | $19.50 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | UE · Used equipment | $144.54 | $144.54 | $144.54 |
CareSource Setting Facility Modifier None Typical Low $141.25 Median $194.98 Typical High $316.23 | Facility | None | $141.25 | $194.98 | $316.23 |
CareSource Setting Professional Modifier None Typical Low $218.78 Median $269.15 Typical High $346.74 | Professional | None | $218.78 | $269.15 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $302.00 | Facility | None | $213.80 | $213.80 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $177.83 Typical High $1,000.00 | Professional | None | $154.88 | $177.83 | $1,000.00 |
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 Professional Modifier None Typical Low $114.82 Median $162.18 Typical High $229.09 | Professional | None | $114.82 | $162.18 | $229.09 |
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 $51.29 Median $57.54 Typical High $85.11 | Professional | 52 · Reduced service | $51.29 | $57.54 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $22.91 Typical High $33.88 | Professional | 53 · Discontinued | $20.42 | $22.91 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $17.38 Typical High $25.12 | Professional | 55 · Aftercare only | $15.49 | $17.38 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $11.48 Typical High $16.98 | Professional | 56 · Pre-op care only | $10.23 | $11.48 | $16.98 |
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
$195
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.