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 $53.70 Median $77.62 Typical High $95.50 | Facility | None | $53.70 | $77.62 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $87.10 Typical High $102.33 | Professional | None | $46.77 | $87.10 | $102.33 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $125.89 Typical High $208.93 | Professional | None | $93.33 | $125.89 | $208.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $93.33 Median $147.91 Typical High $154.88 | Facility | None | $93.33 | $147.91 | $154.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $83.18 Typical High $100.00 | Professional | None | $67.61 | $83.18 | $100.00 |
CareSource Setting Facility Modifier None Typical Low $109.65 Median $144.54 Typical High $213.80 | Facility | None | $109.65 | $144.54 | $213.80 |
CareSource Setting Professional Modifier None Typical Low $144.54 Median $162.18 Typical High $218.78 | Professional | None | $144.54 | $162.18 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $97.72 Typical High $223.87 | Facility | None | $95.50 | $97.72 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $97.72 Typical High $812.83 | Professional | None | $70.79 | $97.72 | $812.83 |
Molina Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $112.20 | Professional | None | $93.33 | $93.33 | $112.20 |
United Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $89.13 | Facility | None | $79.43 | $79.43 | $89.13 |
United Setting Professional Modifier None Typical Low $48.98 Median $72.44 Typical High $109.65 | Professional | None | $48.98 | $72.44 | $109.65 |
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 $32.36 Median $45.71 Typical High $51.29 | Professional | 52 · Reduced service | $32.36 | $45.71 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $18.20 Typical High $20.42 | Professional | 53 · Discontinued | $12.88 | $18.20 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $13.80 Typical High $15.49 | Professional | 55 · Aftercare only | $9.77 | $13.80 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $9.12 Typical High $10.23 | Professional | 56 · Pre-op care only | $6.46 | $9.12 | $10.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | RR · Rental | $8.91 | $8.91 | $8.91 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | UE · Used equipment | $66.07 | $66.07 | $66.07 |
Where Kentucky sits
The same service costs 2.8 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· 49th of 51
$83.18
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.