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 $33.88 Median $56.23 Typical High $58.88 | Facility | None | $33.88 | $56.23 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $56.23 Typical High $61.66 | Professional | None | $33.88 | $56.23 | $61.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $67.61 Median $107.15 Typical High $112.20 | Facility | None | $67.61 | $107.15 | $112.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $48.98 Median $54.95 Typical High $70.79 | Professional | None | $48.98 | $54.95 | $70.79 |
CareSource Setting Facility Modifier None Typical Low $69.18 Median $95.50 Typical High $154.88 | Facility | None | $69.18 | $95.50 | $154.88 |
CareSource Setting Professional Modifier None Typical Low $104.71 Median $131.83 Typical High $169.82 | Professional | None | $104.71 | $131.83 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $147.91 | Facility | None | $67.61 | $67.61 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $67.61 Typical High $512.86 | Professional | None | $50.12 | $67.61 | $512.86 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $81.28 | Professional | None | $67.61 | $67.61 | $81.28 |
United Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $60.26 | Facility | None | $32.36 | $32.36 | $60.26 |
United Setting Professional Modifier None Typical Low $35.48 Median $47.86 Typical High $69.18 | Professional | None | $35.48 | $47.86 | $69.18 |
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 $28.18 Typical High $30.90 | Professional | 52 · Reduced service | $22.39 | $28.18 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $11.22 Typical High $12.30 | Professional | 53 · Discontinued | $8.91 | $11.22 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $8.51 Typical High $9.33 | Professional | 55 · Aftercare only | $6.76 | $8.51 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $5.62 Typical High $6.17 | Professional | 56 · Pre-op care only | $4.47 | $5.62 | $6.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | RR · Rental | $5.62 | $5.62 | $5.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $38.02 Median $42.66 Typical High $42.66 | Professional | UE · Used equipment | $38.02 | $42.66 | $42.66 |
Where Kentucky sits
The same service costs 2.1 times more in Montana 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· 39th of 51
$54.95
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.