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 $37.15 Median $54.95 Typical High $77.62 | Facility | None | $37.15 | $54.95 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $72.44 Typical High $77.62 | Professional | None | $37.15 | $72.44 | $77.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $66.07 Median $104.71 Typical High $109.65 | Facility | None | $66.07 | $104.71 | $109.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $60.26 Typical High $69.18 | Professional | None | $47.86 | $60.26 | $69.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $45.71 Median $60.26 Typical High $60.26 | Professional | UE · Used equipment | $45.71 | $60.26 | $60.26 |
CareSource Setting Facility Modifier None Typical Low $67.61 Median $93.33 Typical High $151.36 | Facility | None | $67.61 | $93.33 | $151.36 |
CareSource Setting Professional Modifier None Typical Low $102.33 Median $128.82 Typical High $165.96 | Professional | None | $102.33 | $128.82 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $162.18 | Facility | None | $64.57 | $64.57 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $64.57 Typical High $588.84 | Professional | None | $46.77 | $64.57 | $588.84 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $79.43 | Professional | None | $66.07 | $66.07 | $79.43 |
United Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $60.26 | Facility | None | $50.12 | $50.12 | $60.26 |
United Setting Professional Modifier None Typical Low $34.67 Median $51.29 Typical High $79.43 | Professional | None | $34.67 | $51.29 | $79.43 |
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 $22.91 Median $36.31 Typical High $38.90 | Professional | 52 · Reduced service | $22.91 | $36.31 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $14.45 Typical High $15.49 | Professional | 53 · Discontinued | $9.12 | $14.45 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $10.96 Typical High $11.48 | Professional | 55 · Aftercare only | $6.92 | $10.96 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $7.24 Typical High $7.76 | Professional | 56 · Pre-op care only | $4.57 | $7.24 | $7.76 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.03 Median $6.03 Typical High $60.26 | Professional | RR · Rental | $6.03 | $6.03 | $60.26 |
Where Kentucky sits
The same service costs 2.8 times more in Wisconsin 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· 42nd of 51
$60.26
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.