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 $107.15 Median $154.88 Typical High $165.96 | Facility | None | $107.15 | $154.88 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $158.49 Typical High $204.17 | Professional | None | $107.15 | $158.49 | $204.17 |
Ambetter Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $186.21 Median $302.00 Typical High $316.23 | Facility | None | $186.21 | $302.00 | $316.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $173.78 Typical High $199.53 | Professional | None | $138.04 | $173.78 | $199.53 |
CareSource Setting Facility Modifier None Typical Low $190.55 Median $263.03 Typical High $426.58 | Facility | None | $190.55 | $263.03 | $426.58 |
CareSource Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $467.74 | Professional | None | $295.12 | $371.54 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $457.09 | Facility | None | $190.55 | $190.55 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $1,621.81 | Professional | None | $138.04 | $190.55 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $223.87 | Professional | None | $186.21 | $186.21 | $223.87 |
United Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $194.98 | Facility | None | $190.55 | $190.55 | $194.98 |
United Setting Professional Modifier None Typical Low $97.72 Median $141.25 Typical High $194.98 | Professional | None | $97.72 | $141.25 | $194.98 |
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 $64.57 Median $79.43 Typical High $102.33 | Professional | 52 · Reduced service | $64.57 | $79.43 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $31.62 Typical High $41.69 | Professional | 53 · Discontinued | $25.70 | $31.62 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $23.99 Typical High $30.90 | Professional | 55 · Aftercare only | $19.50 | $23.99 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $15.85 Typical High $20.42 | Professional | 56 · Pre-op care only | $12.88 | $15.85 | $20.42 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | RR · Rental | $17.78 | $17.78 | $17.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | UE · Used equipment | $131.83 | $131.83 | $131.83 |
Where Kentucky sits
The same service costs 3.5 times more in Hawaii than in Florida. 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· 37th of 51
$174
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.