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 $97.72 Median $141.25 Typical High $169.82 | Facility | None | $97.72 | $141.25 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $158.49 Typical High $169.82 | Professional | None | $85.11 | $158.49 | $169.82 |
Ambetter Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $169.82 Median $269.15 Typical High $288.40 | Facility | None | $169.82 | $269.15 | $288.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $181.97 | Professional | None | $125.89 | $147.91 | $181.97 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $93.33 Median $93.33 Typical High $120.23 | Professional | UE · Used equipment | $93.33 | $93.33 | $120.23 |
CareSource Setting Facility Modifier None Typical Low $173.78 Median $239.88 Typical High $389.05 | Facility | None | $173.78 | $239.88 | $389.05 |
CareSource Setting Professional Modifier None Typical Low $269.15 Median $331.13 Typical High $426.58 | Professional | None | $269.15 | $331.13 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $416.87 | Facility | None | $177.83 | $177.83 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $177.83 Typical High $1,479.11 | Professional | None | $128.82 | $177.83 | $1,479.11 |
Molina Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $204.17 | Professional | None | $169.82 | $169.82 | $204.17 |
United Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $186.21 | Facility | None | $177.83 | $177.83 | $186.21 |
United Setting Professional Modifier None Typical Low $89.13 Median $131.83 Typical High $194.98 | Professional | None | $89.13 | $131.83 | $194.98 |
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 $58.88 Median $81.28 Typical High $93.33 | Professional | 52 · Reduced service | $58.88 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $32.36 Typical High $37.15 | Professional | 53 · Discontinued | $23.44 | $32.36 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $24.55 Typical High $28.18 | Professional | 55 · Aftercare only | $17.78 | $24.55 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $16.22 Typical High $18.62 | Professional | 56 · Pre-op care only | $11.75 | $16.22 | $18.62 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.59 Median $12.59 Typical High $16.22 | Professional | RR · Rental | $12.59 | $12.59 | $16.22 |
Where Kentucky sits
The same service costs 3.5 times more in Hawaii 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· 37th of 51
$148
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.