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 $338.84 Median $371.54 Typical High $389.05 | Facility | None | $338.84 | $371.54 | $389.05 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $407.38 | Professional | None | $338.84 | $371.54 | $407.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $707.95 Typical High $741.31 | Facility | None | $446.68 | $707.95 | $741.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $549.54 | Professional | None | $389.05 | $467.74 | $549.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | RR · Rental | $38.90 | $38.90 | $38.90 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | UE · Used equipment | $295.12 | $295.12 | $295.12 |
CareSource Setting Facility Modifier None Typical Low $457.09 Median $630.96 Typical High $1,000.00 | Facility | None | $457.09 | $630.96 | $1,000.00 |
CareSource Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,122.02 | Professional | None | $691.83 | $870.96 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $977.24 | Facility | None | $436.52 | $436.52 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $436.52 Typical High $3,388.44 | Professional | None | $316.23 | $436.52 | $3,388.44 |
Molina Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $660.69 | Professional | None | $549.54 | $549.54 | $660.69 |
United Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $512.86 | Professional | None | $234.42 | $323.59 | $512.86 |
4 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 $169.82 Median $186.21 Typical High $204.17 | Professional | 52 · Reduced service | $169.82 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $74.13 Typical High $81.28 | Professional | 53 · Discontinued | $67.61 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $56.23 Typical High $60.26 | Professional | 55 · Aftercare only | $51.29 | $56.23 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $37.15 Typical High $40.74 | Professional | 56 · Pre-op care only | $33.88 | $37.15 | $40.74 |
Where Kentucky sits
The same service costs 2.3 times more in Montana 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· 25th of 51
$437
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.