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 $426.58 Median $478.63 Typical High $691.83 | Facility | None | $426.58 | $478.63 | $691.83 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $426.58 Typical High $794.33 | Professional | None | $288.40 | $426.58 | $794.33 |
Ambetter Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $977.24 | Professional | None | $933.25 | $933.25 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $933.25 Typical High $977.24 | Facility | None | $575.44 | $933.25 | $977.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $1,096.48 Typical High $1,288.25 | Professional | None | $741.31 | $1,096.48 | $1,288.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | RR · Rental | $74.13 | $74.13 | $74.13 |
CareSource Setting Facility Modifier None Typical Low $588.84 Median $812.83 Typical High $1,288.25 | Facility | None | $588.84 | $812.83 | $1,288.25 |
CareSource Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $1,445.44 | Professional | None | $891.25 | $1,122.02 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $891.25 Typical High $1,258.93 | Facility | None | $812.83 | $891.25 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $4,168.69 | Professional | None | $588.84 | $741.31 | $4,168.69 |
Cigna Setting Professional Modifier RR · Rental Typical Low $69.18 Median $69.18 Typical High $81.28 | Professional | RR · Rental | $69.18 | $69.18 | $81.28 |
Molina Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,548.82 | Professional | None | $1,288.25 | $1,288.25 | $1,548.82 |
United Setting Professional Modifier None Typical Low $489.78 Median $776.25 Typical High $1,096.48 | Professional | None | $489.78 | $776.25 | $1,096.48 |
6 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 $213.80 Median $239.88 Typical High $346.74 | Professional | 52 · Reduced service | $213.80 | $239.88 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $95.50 Typical High $138.04 | Professional | 53 · Discontinued | $85.11 | $95.50 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $70.79 Typical High $104.71 | Professional | 55 · Aftercare only | $64.57 | $70.79 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $47.86 Typical High $69.18 | Professional | 56 · Pre-op care only | $42.66 | $47.86 | $69.18 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | KX · Policy requirements met | $1,288.25 | $1,288.25 | $1,288.25 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | UE · Used equipment | $562.34 | $562.34 | $562.34 |
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· 19th of 51
$794
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.