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 $56.23 Median $91.20 Typical High $97.72 | Facility | None | $56.23 | $91.20 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $93.33 Typical High $100.00 | Professional | None | $56.23 | $93.33 | $100.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $109.65 Median $177.83 Typical High $186.21 | Facility | None | $109.65 | $177.83 | $186.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $91.20 Typical High $114.82 | Professional | None | $81.28 | $91.20 | $114.82 |
CareSource Setting Facility Modifier None Typical Low $112.20 Median $154.88 Typical High $251.19 | Facility | None | $112.20 | $154.88 | $251.19 |
CareSource Setting Professional Modifier None Typical Low $173.78 Median $218.78 Typical High $275.42 | Professional | None | $173.78 | $218.78 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $239.88 | Facility | None | $117.49 | $117.49 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $117.49 Typical High $851.14 | Professional | None | $85.11 | $117.49 | $851.14 |
Molina Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $131.83 | Professional | None | $109.65 | $109.65 | $131.83 |
United Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
United Setting Professional Modifier None Typical Low $57.54 Median $77.62 Typical High $114.82 | Professional | None | $57.54 | $77.62 | $114.82 |
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 $37.15 Median $46.77 Typical High $50.12 | Professional | 52 · Reduced service | $37.15 | $46.77 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $18.62 Typical High $20.42 | Professional | 53 · Discontinued | $14.79 | $18.62 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $13.80 Typical High $15.14 | Professional | 55 · Aftercare only | $10.96 | $13.80 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $9.33 Typical High $10.00 | Professional | 56 · Pre-op care only | $7.41 | $9.33 | $10.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | RR · Rental | $9.12 | $9.12 | $9.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | UE · Used equipment | $69.18 | $69.18 | $69.18 |
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· 40th of 51
$91.20
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.