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 $117.49 Median $125.89 Typical High $128.82 | Facility | None | $117.49 | $125.89 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $125.89 Typical High $169.82 | Professional | None | $117.49 | $125.89 | $169.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $154.88 Median $251.19 Typical High $263.03 | Facility | None | $154.88 | $251.19 | $263.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $218.78 | Professional | None | $151.36 | $190.55 | $218.78 |
CareSource Setting Facility Modifier None Typical Low $158.49 Median $218.78 Typical High $354.81 | Facility | None | $158.49 | $218.78 | $354.81 |
CareSource Setting Professional Modifier None Typical Low $245.47 Median $309.03 Typical High $389.05 | Professional | None | $245.47 | $309.03 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $338.84 | Facility | None | $213.80 | $213.80 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $199.53 Typical High $1,148.15 | Professional | None | $158.49 | $199.53 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $245.47 | Professional | None | $208.93 | $208.93 | $245.47 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $234.42 | Facility | None | $213.80 | $213.80 | $234.42 |
United Setting Professional Modifier None Typical Low $107.15 Median $158.49 Typical High $213.80 | Professional | None | $107.15 | $158.49 | $213.80 |
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 $60.26 Median $63.10 Typical High $85.11 | Professional | 52 · Reduced service | $60.26 | $63.10 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $25.12 Typical High $34.67 | Professional | 53 · Discontinued | $23.99 | $25.12 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $19.05 Typical High $25.70 | Professional | 55 · Aftercare only | $17.78 | $19.05 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.59 Typical High $16.98 | Professional | 56 · Pre-op care only | $12.02 | $12.59 | $16.98 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | RR · Rental | $19.95 | $19.95 | $19.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $125.89 Median $147.91 Typical High $147.91 | Professional | UE · Used equipment | $125.89 | $147.91 | $147.91 |
Where Kentucky sits
The same service costs 2.9 times more in Hawaii than in Utah. 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· 32nd of 51
$191
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.