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 $851.14 Median $1,479.11 Typical High $1,513.56 | Facility | None | $851.14 | $1,479.11 | $1,513.56 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $1,479.11 Typical High $1,905.46 | Professional | None | $851.14 | $1,479.11 | $1,905.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $2,884.03 Typical High $3,019.95 | Facility | None | $1,819.70 | $2,884.03 | $3,019.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,288.25 Median $1,380.38 Typical High $1,949.84 | Professional | None | $1,288.25 | $1,380.38 | $1,949.84 |
CareSource Setting Facility Modifier None Typical Low $1,862.09 Median $2,570.40 Typical High $4,168.69 | Facility | None | $1,862.09 | $2,570.40 | $4,168.69 |
CareSource Setting Professional Modifier None Typical Low $2,818.38 Median $3,548.13 Typical High $4,570.88 | Professional | None | $2,818.38 | $3,548.13 | $4,570.88 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $3,981.07 | Facility | None | $1,548.82 | $1,548.82 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,548.82 Typical High $12,882.50 | Professional | None | $1,122.02 | $1,548.82 | $12,882.50 |
Molina Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,187.76 | Professional | None | $1,819.70 | $1,819.70 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,659.59 | Facility | None | $1,584.89 | $1,584.89 | $1,659.59 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $1,862.09 | Professional | None | $912.01 | $1,288.25 | $1,862.09 |
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 $537.03 Median $741.31 Typical High $954.99 | Professional | 52 · Reduced service | $537.03 | $741.31 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $295.12 Typical High $389.05 | Professional | 53 · Discontinued | $213.80 | $295.12 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $223.87 Typical High $288.40 | Professional | 55 · Aftercare only | $162.18 | $223.87 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $147.91 Typical High $190.55 | Professional | 56 · Pre-op care only | $107.15 | $147.91 | $190.55 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $147.91 Median $147.91 Typical High $165.96 | Professional | RR · Rental | $147.91 | $147.91 | $165.96 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,122.02 Median $1,122.02 Typical High $1,230.27 | Professional | UE · Used equipment | $1,122.02 | $1,122.02 | $1,230.27 |
Where Kentucky sits
The same service costs 3.1 times more in Hawaii than in Delaware. 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· 41st of 51
$1,380
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.