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 $22.91 Median $35.48 Typical High $42.66 | Facility | None | $22.91 | $35.48 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $35.48 Typical High $45.71 | Professional | None | $22.91 | $35.48 | $45.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $50.12 Median $81.28 Typical High $85.11 | Facility | None | $50.12 | $81.28 | $85.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $37.15 Typical High $53.70 | Professional | None | $30.90 | $37.15 | $53.70 |
CareSource Setting Facility Modifier None Typical Low $51.29 Median $72.44 Typical High $114.82 | Facility | None | $51.29 | $72.44 | $114.82 |
CareSource Setting Professional Modifier None Typical Low $79.43 Median $100.00 Typical High $125.89 | Professional | None | $79.43 | $100.00 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $109.65 | Facility | None | $40.74 | $40.74 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $40.74 Typical High $346.74 | Professional | None | $29.51 | $40.74 | $346.74 |
Molina Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $60.26 | Professional | None | $51.29 | $51.29 | $60.26 |
United Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $40.74 | Facility | None | $36.31 | $36.31 | $40.74 |
United Setting Professional Modifier None Typical Low $23.99 Median $35.48 Typical High $52.48 | Professional | None | $23.99 | $35.48 | $52.48 |
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 $14.45 Median $17.78 Typical High $22.91 | Professional | 52 · Reduced service | $14.45 | $17.78 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $7.08 Typical High $9.12 | Professional | 53 · Discontinued | $5.75 | $7.08 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $5.25 Typical High $6.76 | Professional | 55 · Aftercare only | $4.37 | $5.25 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.55 Typical High $4.57 | Professional | 56 · Pre-op care only | $2.88 | $3.55 | $4.57 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | RR · Rental | $3.72 | $3.72 | $3.72 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $22.91 Median $27.54 Typical High $27.54 | Professional | UE · Used equipment | $22.91 | $27.54 | $27.54 |
Where Kentucky sits
The same service costs 2.7 times more in Montana 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· 35th of 51
$37.15
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.