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 $35.48 Median $66.07 Typical High $72.44 | Facility | None | $35.48 | $66.07 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $69.18 Typical High $87.10 | Professional | None | $35.48 | $69.18 | $87.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $79.43 Median $128.82 Typical High $134.90 | Facility | None | $79.43 | $128.82 | $134.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $57.54 Median $58.88 Typical High $85.11 | Professional | None | $57.54 | $58.88 | $85.11 |
CareSource Setting Facility Modifier None Typical Low $81.28 Median $112.20 Typical High $181.97 | Facility | None | $81.28 | $112.20 | $181.97 |
CareSource Setting Professional Modifier None Typical Low $125.89 Median $158.49 Typical High $199.53 | Professional | None | $125.89 | $158.49 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $173.78 | Facility | None | $83.18 | $83.18 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $83.18 Typical High $549.54 | Professional | None | $61.66 | $83.18 | $549.54 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $95.50 | Professional | None | $79.43 | $79.43 | $95.50 |
United Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $72.44 | Facility | None | $64.57 | $64.57 | $72.44 |
United Setting Professional Modifier None Typical Low $37.15 Median $56.23 Typical High $83.18 | Professional | None | $37.15 | $56.23 | $83.18 |
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 $21.38 Median $34.67 Typical High $43.65 | Professional | 52 · Reduced service | $21.38 | $34.67 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $13.80 Typical High $17.78 | Professional | 53 · Discontinued | $8.51 | $13.80 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $10.47 Typical High $13.18 | Professional | 55 · Aftercare only | $6.31 | $10.47 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $6.92 Typical High $8.71 | Professional | 56 · Pre-op care only | $4.27 | $6.92 | $8.71 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | RR · Rental | $6.03 | $6.03 | $6.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $44.67 Median $44.67 Typical High $47.86 | Professional | UE · Used equipment | $44.67 | $44.67 | $47.86 |
Where Kentucky sits
The same service costs 3.5 times more in Hawaii than in Washington, DC. 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· 45th of 51
$60.26
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.