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 $190.55 Median $295.12 Typical High $363.08 | Facility | None | $190.55 | $295.12 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $295.12 Typical High $478.63 | Professional | None | $239.88 | $295.12 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $426.58 Median $691.83 Typical High $724.44 | Facility | None | $426.58 | $691.83 | $724.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $457.09 | Professional | None | $257.04 | $316.23 | $457.09 |
CareSource Setting Facility Modifier None Typical Low $436.52 Median $616.60 Typical High $977.24 | Facility | None | $436.52 | $616.60 | $977.24 |
CareSource Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $1,096.48 | Professional | None | $676.08 | $851.14 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $933.25 | Facility | None | $371.54 | $371.54 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $371.54 Typical High $2,951.21 | Professional | None | $275.42 | $371.54 | $2,951.21 |
Molina Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $512.86 | Professional | None | $436.52 | $436.52 | $512.86 |
United Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
United Setting Professional Modifier None Typical Low $199.53 Median $309.03 Typical High $446.68 | Professional | None | $199.53 | $309.03 | $446.68 |
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 $120.23 Median $147.91 Typical High $239.88 | Professional | 52 · Reduced service | $120.23 | $147.91 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $58.88 Typical High $95.50 | Professional | 53 · Discontinued | $47.86 | $58.88 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $43.65 Typical High $70.79 | Professional | 55 · Aftercare only | $35.48 | $43.65 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $29.51 Typical High $47.86 | Professional | 56 · Pre-op care only | $23.99 | $29.51 | $47.86 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | RR · Rental | $32.36 | $32.36 | $32.36 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $190.55 Median $239.88 Typical High $239.88 | Professional | UE · Used equipment | $190.55 | $239.88 | $239.88 |
Where Kentucky sits
The same service costs 4.5 times more in Hawaii than in Kansas. 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
$316
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.