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 $24.55 Median $36.31 Typical High $45.71 | Facility | None | $24.55 | $36.31 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $43.65 Typical High $47.86 | Professional | None | $24.55 | $43.65 | $47.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $43.65 Median $69.18 Typical High $74.13 | Facility | None | $43.65 | $69.18 | $74.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $32.36 Median $39.81 Typical High $46.77 | Professional | None | $32.36 | $39.81 | $46.77 |
CareSource Setting Facility Modifier None Typical Low $44.67 Median $61.66 Typical High $100.00 | Facility | None | $44.67 | $61.66 | $100.00 |
CareSource Setting Professional Modifier None Typical Low $69.18 Median $85.11 Typical High $109.65 | Professional | None | $69.18 | $85.11 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $104.71 | Facility | None | $36.31 | $36.31 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $36.31 Typical High $371.54 | Professional | None | $26.92 | $36.31 | $371.54 |
Molina Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $52.48 | Professional | None | $43.65 | $43.65 | $52.48 |
United Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
United Setting Professional Modifier None Typical Low $22.91 Median $33.88 Typical High $51.29 | Professional | None | $22.91 | $33.88 | $51.29 |
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 $15.14 Median $21.88 Typical High $23.99 | Professional | 52 · Reduced service | $15.14 | $21.88 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $8.71 Typical High $9.55 | Professional | 53 · Discontinued | $6.03 | $8.71 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $6.61 Typical High $7.24 | Professional | 55 · Aftercare only | $4.57 | $6.61 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $4.37 Typical High $4.79 | Professional | 56 · Pre-op care only | $3.02 | $4.37 | $4.79 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | RR · Rental | $4.07 | $4.07 | $4.07 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | UE · Used equipment | $30.20 | $30.20 | $30.20 |
Where Kentucky sits
The same service costs 2.9 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· 39th of 51
$39.81
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.