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 $31.62 Median $60.26 Typical High $61.66 | Facility | None | $31.62 | $60.26 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $60.26 Typical High $81.28 | Professional | None | $31.62 | $60.26 | $81.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $72.44 Median $117.49 Typical High $123.03 | Facility | None | $72.44 | $117.49 | $123.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $51.29 Median $53.70 Typical High $77.62 | Professional | None | $51.29 | $53.70 | $77.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $39.81 Median $39.81 Typical High $53.70 | Professional | UE · Used equipment | $39.81 | $39.81 | $53.70 |
CareSource Setting Facility Modifier None Typical Low $74.13 Median $104.71 Typical High $165.96 | Facility | None | $74.13 | $104.71 | $165.96 |
CareSource Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $181.97 | Professional | None | $114.82 | $144.54 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $158.49 | Facility | None | $66.07 | $66.07 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $66.07 Typical High $489.78 | Professional | None | $48.98 | $66.07 | $489.78 |
Molina Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $87.10 | Professional | None | $74.13 | $74.13 | $87.10 |
United Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $58.88 | Facility | None | $47.86 | $47.86 | $58.88 |
United Setting Professional Modifier None Typical Low $33.88 Median $51.29 Typical High $75.86 | Professional | None | $33.88 | $51.29 | $75.86 |
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 $19.05 Median $30.20 Typical High $39.81 | Professional | 52 · Reduced service | $19.05 | $30.20 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $12.02 Typical High $16.22 | Professional | 53 · Discontinued | $7.76 | $12.02 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $8.91 Typical High $12.02 | Professional | 55 · Aftercare only | $5.75 | $8.91 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $6.03 Typical High $8.13 | Professional | 56 · Pre-op care only | $3.80 | $6.03 | $8.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | RR · Rental | $5.25 | $5.25 | $5.25 |
Where Kentucky sits
The same service costs 3.4 times more in Hawaii 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· 38th of 51
$53.70
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.