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 $38.90 Median $58.88 Typical High $72.44 | Facility | None | $38.90 | $58.88 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $70.79 Typical High $79.43 | Professional | None | $38.90 | $70.79 | $79.43 |
Anthem BCBS Setting Facility Modifier None Typical Low $70.79 Median $114.82 Typical High $120.23 | Facility | None | $70.79 | $114.82 | $120.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $63.10 Typical High $75.86 | Professional | None | $52.48 | $63.10 | $75.86 |
CareSource Setting Facility Modifier None Typical Low $72.44 Median $100.00 Typical High $162.18 | Facility | None | $72.44 | $100.00 | $162.18 |
CareSource Setting Professional Modifier None Typical Low $112.20 Median $141.25 Typical High $177.83 | Professional | None | $112.20 | $141.25 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $165.96 | Facility | None | $75.86 | $75.86 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $75.86 Typical High $588.84 | Professional | None | $54.95 | $75.86 | $588.84 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $85.11 | Professional | None | $70.79 | $70.79 | $85.11 |
United Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $72.44 | Facility | None | $69.18 | $69.18 | $72.44 |
United Setting Professional Modifier None Typical Low $37.15 Median $53.70 Typical High $83.18 | Professional | None | $37.15 | $53.70 | $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 $24.55 Median $34.67 Typical High $38.90 | Professional | 52 · Reduced service | $24.55 | $34.67 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $14.13 Typical High $15.85 | Professional | 53 · Discontinued | $9.77 | $14.13 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $10.47 Typical High $11.75 | Professional | 55 · Aftercare only | $7.41 | $10.47 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $7.08 Typical High $7.94 | Professional | 56 · Pre-op care only | $4.90 | $7.08 | $7.94 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | RR · Rental | $6.46 | $6.46 | $6.46 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | UE · Used equipment | $47.86 | $47.86 | $47.86 |
Where Kentucky sits
The same service costs 3.1 times more in Hawaii than in New Jersey. 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· 44th of 51
$63.10
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.