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 $100.00 Median $144.54 Typical High $158.49 | Facility | None | $100.00 | $144.54 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $151.36 Typical High $190.55 | Professional | None | $100.00 | $151.36 | $190.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $173.78 Median $281.84 Typical High $295.12 | Facility | None | $173.78 | $281.84 | $295.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $158.49 Typical High $181.97 | Professional | None | $128.82 | $158.49 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $177.83 Median $245.47 Typical High $398.11 | Facility | None | $177.83 | $245.47 | $398.11 |
CareSource Setting Professional Modifier None Typical Low $275.42 Median $338.84 Typical High $436.52 | Professional | None | $275.42 | $338.84 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $426.58 | Facility | None | $169.82 | $169.82 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $169.82 Typical High $1,513.56 | Professional | None | $125.89 | $169.82 | $1,513.56 |
Molina Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $208.93 | Professional | None | $173.78 | $173.78 | $208.93 |
United Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $229.09 | Facility | None | $181.97 | $181.97 | $229.09 |
United Setting Professional Modifier None Typical Low $93.33 Median $134.90 Typical High $181.97 | Professional | None | $93.33 | $134.90 | $181.97 |
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 $60.26 Median $75.86 Typical High $95.50 | Professional | 52 · Reduced service | $60.26 | $75.86 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $30.20 Typical High $38.02 | Professional | 53 · Discontinued | $23.99 | $30.20 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $22.91 Typical High $28.84 | Professional | 55 · Aftercare only | $17.78 | $22.91 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $15.14 Typical High $19.05 | Professional | 56 · Pre-op care only | $12.02 | $15.14 | $19.05 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | RR · Rental | $16.22 | $16.22 | $16.22 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | UE · Used equipment | $123.03 | $123.03 | $123.03 |
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· 42nd of 51
$158
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.