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 $56.23 Typical High $58.88 | Facility | None | $31.62 | $56.23 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $56.23 Typical High $77.62 | Professional | None | $31.62 | $56.23 | $77.62 |
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 $48.98 Median $52.48 Typical High $75.86 | Professional | None | $48.98 | $52.48 | $75.86 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $39.81 Median $39.81 Typical High $42.66 | Professional | UE · Used equipment | $39.81 | $39.81 | $42.66 |
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 $138.04 Typical High $177.83 | Professional | None | $112.20 | $138.04 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $154.88 | Facility | None | $64.57 | $64.57 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $64.57 Typical High $489.78 | Professional | None | $46.77 | $64.57 | $489.78 |
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 $57.54 Median $57.54 Typical High $60.26 | Facility | None | $57.54 | $57.54 | $60.26 |
United Setting Professional Modifier None Typical Low $33.88 Median $50.12 Typical High $74.13 | Professional | None | $33.88 | $50.12 | $74.13 |
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 $20.89 Median $28.18 Typical High $38.90 | Professional | 52 · Reduced service | $20.89 | $28.18 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $11.22 Typical High $15.49 | Professional | 53 · Discontinued | $8.32 | $11.22 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $8.32 Typical High $11.75 | Professional | 55 · Aftercare only | $6.17 | $8.32 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $5.62 Typical High $7.76 | Professional | 56 · Pre-op care only | $4.17 | $5.62 | $7.76 |
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 3.5 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· 42nd of 51
$52.48
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.