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 $436.52 Median $758.58 Typical High $794.33 | Facility | None | $436.52 | $758.58 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $758.58 Typical High $1,000.00 | Professional | None | $436.52 | $758.58 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $912.01 Median $1,479.11 Typical High $1,548.82 | Facility | None | $912.01 | $1,479.11 | $1,548.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $977.24 | Professional | None | $660.69 | $660.69 | $977.24 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $616.60 Median $616.60 Typical High $630.96 | Professional | UE · Used equipment | $616.60 | $616.60 | $630.96 |
CareSource Setting Facility Modifier None Typical Low $933.25 Median $1,288.25 Typical High $2,089.30 | Facility | None | $933.25 | $1,288.25 | $2,089.30 |
CareSource Setting Professional Modifier None Typical Low $1,445.44 Median $1,819.70 Typical High $2,290.87 | Professional | None | $1,445.44 | $1,819.70 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $1,995.26 | Facility | None | $831.76 | $831.76 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $6,918.31 | Professional | None | $616.60 | $831.76 | $6,918.31 |
Molina Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,096.48 | Professional | None | $912.01 | $912.01 | $1,096.48 |
United Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $794.33 | Facility | None | $630.96 | $630.96 | $794.33 |
United Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $954.99 | Professional | None | $478.63 | $645.65 | $954.99 |
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 $309.03 Median $380.19 Typical High $501.19 | Professional | 52 · Reduced service | $309.03 | $380.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $151.36 Typical High $199.53 | Professional | 53 · Discontinued | $123.03 | $151.36 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $114.82 Typical High $151.36 | Professional | 55 · Aftercare only | $91.20 | $114.82 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $75.86 Typical High $100.00 | Professional | 56 · Pre-op care only | $61.66 | $75.86 | $100.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | RR · Rental | $83.18 | $83.18 | $83.18 |
Where Kentucky sits
The same service costs 3.2 times more in Hawaii than in Delaware. 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· 41st of 51
$724
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.