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 $19.50 Median $28.18 Typical High $33.88 | Facility | None | $19.50 | $28.18 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $23.44 Median $32.36 Typical High $37.15 | Professional | None | $23.44 | $32.36 | $37.15 |
Ambetter Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Anthem BCBS Setting Facility Modifier None Typical Low $33.88 Median $54.95 Typical High $57.54 | Facility | None | $33.88 | $54.95 | $57.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.12 Median $31.62 Typical High $36.31 | Professional | None | $25.12 | $31.62 | $36.31 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $23.99 Median $23.99 Typical High $33.11 | Professional | UE · Used equipment | $23.99 | $23.99 | $33.11 |
CareSource Setting Facility Modifier None Typical Low $34.67 Median $47.86 Typical High $77.62 | Facility | None | $34.67 | $47.86 | $77.62 |
CareSource Setting Professional Modifier None Typical Low $53.70 Median $67.61 Typical High $85.11 | Professional | None | $53.70 | $67.61 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $87.10 | Facility | None | $38.90 | $38.90 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $38.90 Typical High $309.03 | Professional | None | $28.84 | $38.90 | $309.03 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $40.74 | Professional | None | $33.88 | $33.88 | $40.74 |
United Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $51.29 | Facility | None | $35.48 | $35.48 | $51.29 |
United Setting Professional Modifier None Typical Low $18.20 Median $26.92 Typical High $38.90 | Professional | None | $18.20 | $26.92 | $38.90 |
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 $11.75 Median $16.22 Typical High $18.62 | Professional | 52 · Reduced service | $11.75 | $16.22 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.68 Median $6.46 Typical High $7.59 | Professional | 53 · Discontinued | $4.68 | $6.46 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $4.90 Typical High $5.62 | Professional | 55 · Aftercare only | $3.55 | $4.90 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.34 Median $3.24 Typical High $3.72 | Professional | 56 · Pre-op care only | $2.34 | $3.24 | $3.72 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | RR · Rental | $3.24 | $3.24 | $3.24 |
Where Kentucky sits
The same service costs 4.7 times more in Hawaii 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· 40th of 51
$31.62
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.