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 $35.48 Median $57.54 Typical High $61.66 | Facility | None | $35.48 | $57.54 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $57.54 Typical High $61.66 | Professional | None | $35.48 | $57.54 | $61.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $74.13 Median $120.23 Typical High $125.89 | Facility | None | $74.13 | $120.23 | $125.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $57.54 Typical High $79.43 | Professional | None | $50.12 | $57.54 | $79.43 |
CareSource Setting Facility Modifier None Typical Low $75.86 Median $104.71 Typical High $169.82 | Facility | None | $75.86 | $104.71 | $169.82 |
CareSource Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $186.21 | Professional | None | $117.49 | $144.54 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $162.18 | Facility | None | $61.66 | $61.66 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $61.66 Typical High $524.81 | Professional | None | $44.67 | $61.66 | $524.81 |
Molina Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $89.13 | Professional | None | $74.13 | $74.13 | $89.13 |
United Setting Facility Modifier None Typical Low $29.51 Median $29.51 Typical High $48.98 | Facility | None | $29.51 | $29.51 | $48.98 |
United Setting Professional Modifier None Typical Low $38.02 Median $52.48 Typical High $77.62 | Professional | None | $38.02 | $52.48 | $77.62 |
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 $22.39 Median $28.84 Typical High $30.90 | Professional | 52 · Reduced service | $22.39 | $28.84 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $11.48 Typical High $12.30 | Professional | 53 · Discontinued | $8.91 | $11.48 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $8.71 Typical High $9.33 | Professional | 55 · Aftercare only | $6.61 | $8.71 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $5.75 Typical High $6.17 | Professional | 56 · Pre-op care only | $4.47 | $5.75 | $6.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | RR · Rental | $6.03 | $6.03 | $6.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | UE · Used equipment | $44.67 | $44.67 | $44.67 |
Where Kentucky sits
The same service costs 2.4 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· 41st of 51
$57.54
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.