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 $316.23 Median $489.78 Typical High $575.44 | Facility | None | $316.23 | $489.78 | $575.44 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $489.78 Typical High $676.08 | Professional | None | $316.23 | $489.78 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $676.08 Median $1,096.48 Typical High $1,148.15 | Facility | None | $676.08 | $1,096.48 | $1,148.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $691.83 | Professional | None | $426.58 | $512.86 | $691.83 |
CareSource Setting Facility Modifier None Typical Low $691.83 Median $977.24 Typical High $1,548.82 | Facility | None | $691.83 | $977.24 | $1,548.82 |
CareSource Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $1,737.80 | Professional | None | $1,071.52 | $1,348.96 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $1,479.11 | Facility | None | $562.34 | $562.34 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $4,897.79 | Professional | None | $416.87 | $562.34 | $4,897.79 |
Molina Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $812.83 | Professional | None | $691.83 | $691.83 | $812.83 |
United Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $660.69 | Facility | None | $549.54 | $549.54 | $660.69 |
United Setting Professional Modifier None Typical Low $338.84 Median $478.63 Typical High $707.95 | Professional | None | $338.84 | $478.63 | $707.95 |
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 $199.53 Median $245.47 Typical High $338.84 | Professional | 52 · Reduced service | $199.53 | $245.47 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $97.72 Typical High $134.90 | Professional | 53 · Discontinued | $79.43 | $97.72 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $74.13 Typical High $102.33 | Professional | 55 · Aftercare only | $60.26 | $74.13 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $48.98 Typical High $67.61 | Professional | 56 · Pre-op care only | $39.81 | $48.98 | $67.61 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | RR · Rental | $52.48 | $52.48 | $52.48 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | UE · Used equipment | $398.11 | $398.11 | $398.11 |
Where Kentucky sits
The same service costs 3.6 times more in Hawaii than in Kansas. 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
$513
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.