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 $363.08 Median $380.19 Typical High $537.03 | Facility | None | $363.08 | $380.19 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $380.19 Typical High $537.03 | Professional | None | $363.08 | $380.19 | $537.03 |
Ambetter Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $457.09 Median $741.31 Typical High $776.25 | Facility | None | $457.09 | $741.31 | $776.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $741.31 | Professional | None | $524.81 | $691.83 | $741.31 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | RR · Rental | $69.18 | $69.18 | $69.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | UE · Used equipment | $512.86 | $512.86 | $512.86 |
CareSource Setting Facility Modifier None Typical Low $467.74 Median $645.65 Typical High $1,047.13 | Facility | None | $467.74 | $645.65 | $1,047.13 |
CareSource Setting Professional Modifier None Typical Low $707.95 Median $891.25 Typical High $1,148.15 | Professional | None | $707.95 | $891.25 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $707.95 Typical High $1,000.00 | Facility | None | $630.96 | $707.95 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $3,311.31 | Professional | None | $467.74 | $588.84 | $3,311.31 |
Molina Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
United Setting Professional Modifier None Typical Low $363.08 Median $524.81 Typical High $724.44 | Professional | None | $363.08 | $524.81 | $724.44 |
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 $181.97 Median $190.55 Typical High $269.15 | Professional | 52 · Reduced service | $181.97 | $190.55 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $75.86 Typical High $107.15 | Professional | 53 · Discontinued | $74.13 | $75.86 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $56.23 Typical High $81.28 | Professional | 55 · Aftercare only | $54.95 | $56.23 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $38.02 Typical High $53.70 | Professional | 56 · Pre-op care only | $36.31 | $38.02 | $53.70 |
Where Kentucky sits
The same service costs 2.2 times more in Kansas 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· 41st of 51
$537
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.