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 $87.10 | Facility | None | $51.29 | $77.62 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $85.11 Typical High $102.33 | Professional | None | $64.57 | $85.11 | $102.33 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $123.03 Typical High $128.82 | Professional | None | $120.23 | $123.03 | $128.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $93.33 Median $151.36 Typical High $158.49 | Facility | None | $93.33 | $151.36 | $158.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $69.18 Median $75.86 Typical High $100.00 | Professional | None | $69.18 | $75.86 | $100.00 |
CareSource Setting Facility Modifier None Typical Low $109.65 Median $147.91 Typical High $213.80 | Facility | None | $109.65 | $147.91 | $213.80 |
CareSource Setting Professional Modifier None Typical Low $147.91 Median $162.18 Typical High $218.78 | Professional | None | $147.91 | $162.18 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $218.78 | Facility | None | $102.33 | $102.33 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $102.33 Typical High $776.25 | Professional | None | $74.13 | $102.33 | $776.25 |
Molina Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $112.20 | Professional | None | $93.33 | $93.33 | $112.20 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
United Setting Professional Modifier None Typical Low $48.98 Median $70.79 Typical High $107.15 | Professional | None | $48.98 | $70.79 | $107.15 |
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 $32.36 Median $42.66 Typical High $51.29 | Professional | 52 · Reduced service | $32.36 | $42.66 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $16.98 Typical High $20.42 | Professional | 53 · Discontinued | $12.88 | $16.98 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $12.59 Typical High $15.49 | Professional | 55 · Aftercare only | $9.77 | $12.59 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $8.51 Typical High $10.23 | Professional | 56 · Pre-op care only | $6.46 | $8.51 | $10.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | RR · Rental | $8.51 | $8.51 | $8.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | UE · Used equipment | $63.10 | $63.10 | $63.10 |
Where Kentucky sits
The same service costs 2.9 times more in Hawaii than in New Jersey. 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· 46th of 51
$77.62
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.