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 $109.65 Median $158.49 Typical High $190.55 | Facility | None | $109.65 | $158.49 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $181.97 Typical High $208.93 | Professional | None | $131.83 | $181.97 | $208.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $190.55 Median $309.03 Typical High $323.59 | Facility | None | $190.55 | $309.03 | $323.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $141.25 Median $177.83 Typical High $204.17 | Professional | None | $141.25 | $177.83 | $204.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $131.83 Median $138.04 Typical High $138.04 | Professional | UE · Used equipment | $131.83 | $138.04 | $138.04 |
CareSource Setting Facility Modifier None Typical Low $194.98 Median $269.15 Typical High $436.52 | Facility | None | $194.98 | $269.15 | $436.52 |
CareSource Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $478.63 | Professional | None | $302.00 | $380.19 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $467.74 | Facility | None | $218.78 | $218.78 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $218.78 Typical High $1,698.24 | Professional | None | $158.49 | $218.78 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $229.09 | Professional | None | $190.55 | $190.55 | $229.09 |
United Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $204.17 | Facility | None | $199.53 | $199.53 | $204.17 |
United Setting Professional Modifier None Typical Low $102.33 Median $151.36 Typical High $213.80 | Professional | None | $102.33 | $151.36 | $213.80 |
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 $66.07 Median $91.20 Typical High $104.71 | Professional | 52 · Reduced service | $66.07 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $36.31 Typical High $42.66 | Professional | 53 · Discontinued | $26.92 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $26.92 Typical High $31.62 | Professional | 55 · Aftercare only | $19.95 | $26.92 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $18.20 Typical High $20.89 | Professional | 56 · Pre-op care only | $13.18 | $18.20 | $20.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | RR · Rental | $18.20 | $18.20 | $18.20 |
Where Kentucky sits
The same service costs 3.3 times more in Hawaii than in West Virginia. 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· 39th of 51
$178
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.