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 $72.44 Median $109.65 Typical High $138.04 | Facility | None | $72.44 | $109.65 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $131.83 Typical High $138.04 | Professional | None | $72.44 | $131.83 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $131.83 Median $208.93 Typical High $218.78 | Facility | None | $131.83 | $208.93 | $218.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $120.23 Typical High $134.90 | Professional | None | $95.50 | $120.23 | $134.90 |
CareSource Setting Facility Modifier None Typical Low $134.90 Median $186.21 Typical High $295.12 | Facility | None | $134.90 | $186.21 | $295.12 |
CareSource Setting Professional Modifier None Typical Low $204.17 Median $257.04 Typical High $331.13 | Professional | None | $204.17 | $257.04 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $309.03 | Facility | None | $144.54 | $144.54 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $144.54 Typical High $1,122.02 | Professional | None | $104.71 | $144.54 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $158.49 | Professional | None | $131.83 | $131.83 | $158.49 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $100.00 | Facility | None | $87.10 | $87.10 | $100.00 |
United Setting Professional Modifier None Typical Low $69.18 Median $100.00 Typical High $151.36 | Professional | None | $69.18 | $100.00 | $151.36 |
6 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 $66.07 Typical High $67.61 | Professional | 52 · Reduced service | $45.71 | $66.07 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $26.30 Typical High $27.54 | Professional | 53 · Discontinued | $18.20 | $26.30 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $19.50 Typical High $20.42 | Professional | 55 · Aftercare only | $13.49 | $19.50 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $13.18 Typical High $13.80 | Professional | 56 · Pre-op care only | $9.12 | $13.18 | $13.80 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | RR · Rental | $12.02 | $12.02 | $12.02 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | UE · Used equipment | $89.13 | $89.13 | $89.13 |
Where Kentucky sits
The same service costs 2.5 times more in Montana than in Florida. 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· 41st of 51
$120
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.