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 $41.69 Median $66.07 Typical High $69.18 | Facility | None | $41.69 | $66.07 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $66.07 Typical High $91.20 | Professional | None | $50.12 | $66.07 | $91.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $83.18 Median $134.90 Typical High $141.25 | Facility | None | $83.18 | $134.90 | $141.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $57.54 Median $67.61 Typical High $89.13 | Professional | None | $57.54 | $67.61 | $89.13 |
CareSource Setting Facility Modifier None Typical Low $85.11 Median $117.49 Typical High $190.55 | Facility | None | $85.11 | $117.49 | $190.55 |
CareSource Setting Professional Modifier None Typical Low $131.83 Median $165.96 Typical High $208.93 | Professional | None | $131.83 | $165.96 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $181.97 | Facility | None | $75.86 | $75.86 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $75.86 Typical High $645.65 | Professional | None | $54.95 | $75.86 | $645.65 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $100.00 | Professional | None | $83.18 | $83.18 | $100.00 |
United Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $87.10 | Facility | None | $77.62 | $77.62 | $87.10 |
United Setting Professional Modifier None Typical Low $43.65 Median $58.88 Typical High $87.10 | Professional | None | $43.65 | $58.88 | $87.10 |
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 $25.12 Median $33.11 Typical High $45.71 | Professional | 52 · Reduced service | $25.12 | $33.11 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $13.18 Typical High $18.62 | Professional | 53 · Discontinued | $10.23 | $13.18 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $9.77 Typical High $13.80 | Professional | 55 · Aftercare only | $7.59 | $9.77 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $6.61 Typical High $9.12 | Professional | 56 · Pre-op care only | $5.13 | $6.61 | $9.12 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | RR · Rental | $7.08 | $7.08 | $7.08 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $52.48 Typical High $52.48 | Professional | UE · Used equipment | $42.66 | $52.48 | $52.48 |
Where Kentucky sits
The same service costs 4.4 times more in Kansas than in Vermont. 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· 43rd of 51
$67.61
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.