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 $27.54 Median $42.66 Typical High $45.71 | Facility | None | $27.54 | $42.66 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $42.66 Typical High $60.26 | Professional | None | $33.11 | $42.66 | $60.26 |
Ambetter Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $54.95 Median $89.13 Typical High $93.33 | Facility | None | $54.95 | $89.13 | $93.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $37.15 Median $44.67 Typical High $58.88 | Professional | None | $37.15 | $44.67 | $58.88 |
CareSource Setting Facility Modifier None Typical Low $56.23 Median $77.62 Typical High $125.89 | Facility | None | $56.23 | $77.62 | $125.89 |
CareSource Setting Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $138.04 | Professional | None | $87.10 | $109.65 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $120.23 | Facility | None | $48.98 | $48.98 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $48.98 Typical High $416.87 | Professional | None | $35.48 | $48.98 | $416.87 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $66.07 | Professional | None | $54.95 | $54.95 | $66.07 |
United Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $64.57 | Facility | None | $50.12 | $50.12 | $64.57 |
United Setting Professional Modifier None Typical Low $28.84 Median $38.90 Typical High $57.54 | Professional | None | $28.84 | $38.90 | $57.54 |
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 $16.60 Median $21.38 Typical High $30.20 | Professional | 52 · Reduced service | $16.60 | $21.38 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $8.51 Typical High $12.30 | Professional | 53 · Discontinued | $6.61 | $8.51 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $6.31 Typical High $9.12 | Professional | 55 · Aftercare only | $5.01 | $6.31 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $4.27 Typical High $6.03 | Professional | 56 · Pre-op care only | $3.31 | $4.27 | $6.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | RR · Rental | $4.57 | $4.57 | $4.57 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | UE · Used equipment | $33.88 | $33.88 | $33.88 |
Where Kentucky sits
The same service costs 4.7 times more in Hawaii 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· 38th of 51
$44.67
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.