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 $831.76 Median $1,348.96 Typical High $1,380.38 | Facility | None | $831.76 | $1,348.96 | $1,380.38 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $1,819.70 | Professional | None | $1,047.13 | $1,348.96 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $2,630.27 Typical High $2,818.38 | Facility | None | $1,659.59 | $2,630.27 | $2,818.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,348.96 Typical High $1,778.28 | Professional | None | $1,174.90 | $1,348.96 | $1,778.28 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,000.00 Median $1,047.13 Typical High $1,047.13 | Professional | UE · Used equipment | $1,000.00 | $1,047.13 | $1,047.13 |
CareSource Setting Facility Modifier None Typical Low $1,698.24 Median $2,344.23 Typical High $3,801.89 | Facility | None | $1,698.24 | $2,344.23 | $3,801.89 |
CareSource Setting Professional Modifier None Typical Low $2,630.27 Median $3,235.94 Typical High $4,168.69 | Professional | None | $2,630.27 | $3,235.94 | $4,168.69 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $3,630.78 | Facility | None | $1,698.24 | $1,698.24 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,698.24 Typical High $12,302.69 | Professional | None | $1,230.27 | $1,698.24 | $12,302.69 |
Molina Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,995.26 | Professional | None | $1,659.59 | $1,659.59 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,513.56 | $1,513.56 | $1,513.56 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,737.80 | Professional | None | $870.96 | $1,174.90 | $1,737.80 |
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 $524.81 Median $676.08 Typical High $912.01 | Professional | 52 · Reduced service | $524.81 | $676.08 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $269.15 Typical High $363.08 | Professional | 53 · Discontinued | $208.93 | $269.15 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $199.53 Typical High $275.42 | Professional | 55 · Aftercare only | $158.49 | $199.53 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $134.90 Typical High $181.97 | Professional | 56 · Pre-op care only | $104.71 | $134.90 | $181.97 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | RR · Rental | $138.04 | $138.04 | $138.04 |
Where Kentucky sits
The same service costs 2.8 times more in Hawaii than in Arizona. 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· 34th of 51
$1,349
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.