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 $51.29 Median $77.62 Typical High $97.72 | Facility | None | $51.29 | $77.62 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $77.62 Typical High $97.72 | Professional | None | $51.29 | $77.62 | $97.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $117.49 Median $190.55 Typical High $199.53 | Facility | None | $117.49 | $190.55 | $199.53 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $81.28 Typical High $125.89 | Professional | None | $67.61 | $81.28 | $125.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $51.29 Median $61.66 Typical High $61.66 | Professional | UE · Used equipment | $51.29 | $61.66 | $61.66 |
CareSource Setting Facility Modifier None Typical Low $120.23 Median $165.96 Typical High $269.15 | Facility | None | $120.23 | $165.96 | $269.15 |
CareSource Setting Professional Modifier None Typical Low $186.21 Median $234.42 Typical High $295.12 | Professional | None | $186.21 | $234.42 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $257.04 | Facility | None | $91.20 | $91.20 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $91.20 Typical High $741.31 | Professional | None | $66.07 | $91.20 | $741.31 |
Molina Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $141.25 | Professional | None | $117.49 | $117.49 | $141.25 |
United Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $69.18 | Facility | None | $39.81 | $39.81 | $69.18 |
United Setting Professional Modifier None Typical Low $53.70 Median $83.18 Typical High $123.03 | Professional | None | $53.70 | $83.18 | $123.03 |
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 $31.62 Median $38.90 Typical High $48.98 | Professional | 52 · Reduced service | $31.62 | $38.90 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $15.49 Typical High $19.50 | Professional | 53 · Discontinued | $12.59 | $15.49 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $11.75 Typical High $14.79 | Professional | 55 · Aftercare only | $9.55 | $11.75 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.76 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.31 | $7.76 | $9.77 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | RR · Rental | $8.13 | $8.13 | $8.13 |
Where Kentucky sits
The same service costs 2.5 times more in Montana 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· 40th of 51
$81.28
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.