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 $67.61 Median $112.20 Typical High $117.49 | Facility | None | $67.61 | $112.20 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $112.20 Typical High $123.03 | Professional | None | $67.61 | $112.20 | $123.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $131.83 Median $213.80 Typical High $223.87 | Facility | None | $131.83 | $213.80 | $223.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $102.33 Typical High $141.25 | Professional | None | $97.72 | $102.33 | $141.25 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | UE · Used equipment | $85.11 | $85.11 | $85.11 |
CareSource Setting Facility Modifier None Typical Low $134.90 Median $190.55 Typical High $302.00 | Facility | None | $134.90 | $190.55 | $302.00 |
CareSource Setting Professional Modifier None Typical Low $208.93 Median $263.03 Typical High $338.84 | Professional | None | $208.93 | $263.03 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $288.40 | Facility | None | $147.91 | $147.91 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $1,023.29 | Professional | None | $107.15 | $147.91 | $1,023.29 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $162.18 | Professional | None | $134.90 | $134.90 | $162.18 |
United Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
United Setting Professional Modifier None Typical Low $69.18 Median $95.50 Typical High $138.04 | Professional | None | $69.18 | $95.50 | $138.04 |
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 $45.71 Median $56.23 Typical High $61.66 | Professional | 52 · Reduced service | $45.71 | $56.23 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $22.39 Typical High $24.55 | Professional | 53 · Discontinued | $18.20 | $22.39 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $16.98 Typical High $18.62 | Professional | 55 · Aftercare only | $13.49 | $16.98 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $11.22 Typical High $12.30 | Professional | 56 · Pre-op care only | $9.12 | $11.22 | $12.30 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | RR · Rental | $11.48 | $11.48 | $11.48 |
Where Kentucky sits
The same service costs 5.4 times more in Kansas 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· 42nd of 51
$107
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.