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 $64.57 Median $93.33 Typical High $97.72 | Facility | None | $64.57 | $93.33 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $95.50 Typical High $123.03 | Professional | None | $64.57 | $95.50 | $123.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $112.20 Median $177.83 Typical High $190.55 | Facility | None | $112.20 | $177.83 | $190.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $102.33 Typical High $120.23 | Professional | None | $83.18 | $102.33 | $120.23 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $77.62 Median $81.28 Typical High $81.28 | Professional | UE · Used equipment | $77.62 | $81.28 | $81.28 |
CareSource Setting Facility Modifier None Typical Low $114.82 Median $158.49 Typical High $257.04 | Facility | None | $114.82 | $158.49 | $257.04 |
CareSource Setting Professional Modifier None Typical Low $177.83 Median $218.78 Typical High $281.84 | Professional | None | $177.83 | $218.78 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $269.15 | Facility | None | $109.65 | $109.65 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $109.65 Typical High $954.99 | Professional | None | $81.28 | $109.65 | $954.99 |
Molina Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $134.90 | Professional | None | $112.20 | $112.20 | $134.90 |
United Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $107.15 | Facility | None | $89.13 | $89.13 | $107.15 |
United Setting Professional Modifier None Typical Low $58.88 Median $85.11 Typical High $120.23 | Professional | None | $58.88 | $85.11 | $120.23 |
5 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 $38.90 Median $47.86 Typical High $61.66 | Professional | 52 · Reduced service | $38.90 | $47.86 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $19.05 Typical High $24.55 | Professional | 53 · Discontinued | $15.49 | $19.05 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $14.13 Typical High $18.62 | Professional | 55 · Aftercare only | $11.48 | $14.13 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $9.55 Typical High $12.30 | Professional | 56 · Pre-op care only | $7.76 | $9.55 | $12.30 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | RR · Rental | $10.72 | $10.72 | $10.72 |
Where Kentucky sits
The same service costs 3.0 times more in Montana 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· 40th of 51
$102
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.