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 $288.40 Median $467.74 Typical High $489.78 | Facility | None | $288.40 | $467.74 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $501.19 | Professional | None | $389.05 | $467.74 | $501.19 |
Ambetter Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $707.95 | Professional | None | $630.96 | $707.95 | $707.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $933.25 Typical High $1,000.00 | Facility | None | $588.84 | $933.25 | $1,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $436.52 Typical High $630.96 | Professional | None | $407.38 | $436.52 | $630.96 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | UE · Used equipment | $407.38 | $407.38 | $407.38 |
CareSource Setting Facility Modifier None Typical Low $602.56 Median $831.76 Typical High $1,348.96 | Facility | None | $602.56 | $831.76 | $1,348.96 |
CareSource Setting Professional Modifier None Typical Low $933.25 Median $1,148.15 Typical High $1,479.11 | Professional | None | $933.25 | $1,148.15 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $1,288.25 | Facility | None | $549.54 | $549.54 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $549.54 Typical High $4,466.84 | Professional | None | $398.11 | $549.54 | $4,466.84 |
Molina Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $707.95 | Professional | None | $588.84 | $588.84 | $707.95 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $436.52 | Facility | None | $331.13 | $331.13 | $436.52 |
United Setting Professional Modifier None Typical Low $309.03 Median $416.87 Typical High $602.56 | Professional | None | $309.03 | $416.87 | $602.56 |
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 $181.97 Median $234.42 Typical High $251.19 | Professional | 52 · Reduced service | $181.97 | $234.42 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $93.33 Typical High $102.33 | Professional | 53 · Discontinued | $72.44 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $70.79 Typical High $75.86 | Professional | 55 · Aftercare only | $54.95 | $70.79 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $46.77 Typical High $50.12 | Professional | 56 · Pre-op care only | $36.31 | $46.77 | $50.12 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | RR · Rental | $53.70 | $53.70 | $53.70 |
Where Kentucky sits
The same service costs 2.4 times more in Iowa 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· 45th of 51
$447
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.