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 $7.08 Median $10.47 Typical High $11.48 | Facility | None | $7.08 | $10.47 | $11.48 |
Aetna Setting Professional Modifier None Typical Low $7.08 Median $10.96 Typical High $11.48 | Professional | None | $7.08 | $10.96 | $11.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $12.59 Median $19.95 Typical High $20.89 | Facility | None | $12.59 | $19.95 | $20.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.12 Median $11.48 Typical High $13.18 | Professional | None | $9.12 | $11.48 | $13.18 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.15 Median $1.15 Typical High $10.00 | Professional | RR · Rental | $1.15 | $1.15 | $10.00 |
CareSource Setting Facility Modifier None Typical Low $12.88 Median $17.78 Typical High $28.84 | Facility | None | $12.88 | $17.78 | $28.84 |
CareSource Setting Professional Modifier None Typical Low $19.50 Median $24.55 Typical High $31.62 | Professional | None | $19.50 | $24.55 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $30.20 | Facility | None | $13.49 | $13.49 | $30.20 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $13.49 Typical High $107.15 | Professional | None | $9.77 | $13.49 | $107.15 |
Molina Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $15.14 | Professional | None | $12.59 | $12.59 | $15.14 |
United Setting Facility Modifier None Typical Low $7.94 Median $7.94 Typical High $9.77 | Facility | None | $7.94 | $7.94 | $9.77 |
United Setting Professional Modifier None Typical Low $6.61 Median $9.55 Typical High $13.18 | Professional | None | $6.61 | $9.55 | $13.18 |
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 $4.37 Median $5.50 Typical High $5.75 | Professional | 52 · Reduced service | $4.37 | $5.50 | $5.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.74 Median $2.19 Typical High $2.29 | Professional | 53 · Discontinued | $1.74 | $2.19 | $2.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.29 Median $1.66 Typical High $1.74 | Professional | 55 · Aftercare only | $1.29 | $1.66 | $1.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.87 Median $1.12 Typical High $1.15 | Professional | 56 · Pre-op care only | $0.87 | $1.12 | $1.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | UE · Used equipment | $8.71 | $8.71 | $8.71 |
Where Kentucky sits
The same service costs 2.5 times more in Arkansas than in Kansas. 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
$11.48
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.