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 $645.65 Median $1,047.13 Typical High $1,202.26 | Facility | None | $645.65 | $1,047.13 | $1,202.26 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $1,148.15 Typical High $1,380.38 | Professional | None | $645.65 | $1,148.15 | $1,380.38 |
Ambetter Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,230.27 Median $1,995.26 Typical High $2,089.30 | Facility | None | $1,230.27 | $1,995.26 | $2,089.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,318.26 | Professional | None | $912.01 | $1,047.13 | $1,318.26 |
CareSource Setting Facility Modifier None Typical Low $1,258.93 Median $1,778.28 Typical High $2,818.38 | Facility | None | $1,258.93 | $1,778.28 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $1,949.84 Median $2,454.71 Typical High $3,162.28 | Professional | None | $1,949.84 | $2,454.71 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $2,884.03 | Facility | None | $1,174.90 | $1,174.90 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $10,232.93 | Professional | None | $870.96 | $1,174.90 | $10,232.93 |
Molina Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,513.56 | Professional | None | $1,258.93 | $1,258.93 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,479.11 | Facility | None | $1,174.90 | $1,174.90 | $1,479.11 |
United Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $1,348.96 | Professional | None | $645.65 | $912.01 | $1,348.96 |
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 $398.11 Median $575.44 Typical High $691.83 | Professional | 52 · Reduced service | $398.11 | $575.44 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $229.09 Typical High $275.42 | Professional | 53 · Discontinued | $162.18 | $229.09 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $173.78 Typical High $204.17 | Professional | 55 · Aftercare only | $120.23 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $114.82 Typical High $138.04 | Professional | 56 · Pre-op care only | $81.28 | $114.82 | $138.04 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | RR · Rental | $114.82 | $114.82 | $114.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | UE · Used equipment | $851.14 | $851.14 | $851.14 |
Where Kentucky sits
The same service costs 4.0 times more in Hawaii than in Pennsylvania. 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· 40th of 51
$1,047
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.