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 $363.08 Typical High $380.19 | Facility | None | $363.08 | $363.08 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $380.19 Typical High $416.87 | Professional | None | $354.81 | $380.19 | $416.87 |
Ambetter Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $588.84 | Professional | None | $537.03 | $537.03 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $436.52 Median $691.83 Typical High $724.44 | Facility | None | $436.52 | $691.83 | $724.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $457.09 | Professional | None | $316.23 | $354.81 | $457.09 |
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 $446.68 Median $616.60 Typical High $977.24 | Facility | None | $446.68 | $616.60 | $977.24 |
CareSource Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $1,096.48 | Professional | None | $676.08 | $851.14 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $954.99 | Facility | None | $416.87 | $416.87 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $416.87 Typical High $3,311.31 | Professional | None | $309.03 | $416.87 | $3,311.31 |
Molina Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $436.52 | Professional | None | $363.08 | $363.08 | $436.52 |
United Setting Professional Modifier None Typical Low $229.09 Median $309.03 Typical High $446.68 | Professional | None | $229.09 | $309.03 | $446.68 |
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 $165.96 Median $190.55 Typical High $199.53 | Professional | 52 · Reduced service | $165.96 | $190.55 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $75.86 Typical High $79.43 | Professional | 53 · Discontinued | $67.61 | $75.86 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $57.54 Typical High $58.88 | Professional | 55 · Aftercare only | $50.12 | $57.54 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $38.02 Typical High $39.81 | Professional | 56 · Pre-op care only | $33.88 | $38.02 | $39.81 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | RR · Rental | $39.81 | $39.81 | $39.81 |
Where Kentucky sits
The same service costs 2.2 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· 44th of 51
$355
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.