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 $27.54 Median $42.66 Typical High $42.66 | Facility | None | $27.54 | $42.66 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $42.66 Typical High $56.23 | Professional | None | $27.54 | $42.66 | $56.23 |
Ambetter Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $51.29 Median $83.18 Typical High $87.10 | Facility | None | $51.29 | $83.18 | $87.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $37.15 Median $38.02 Typical High $54.95 | Professional | None | $37.15 | $38.02 | $54.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $28.18 Median $34.67 Typical High $34.67 | Professional | UE · Used equipment | $28.18 | $34.67 | $34.67 |
CareSource Setting Facility Modifier None Typical Low $52.48 Median $72.44 Typical High $117.49 | Facility | None | $52.48 | $72.44 | $117.49 |
CareSource Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $128.82 | Professional | None | $81.28 | $102.33 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $117.49 | Facility | None | $53.70 | $53.70 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $53.70 Typical High $416.87 | Professional | None | $39.81 | $53.70 | $416.87 |
Molina Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $61.66 | Professional | None | $51.29 | $51.29 | $61.66 |
United Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $51.29 | Facility | None | $47.86 | $47.86 | $51.29 |
United Setting Professional Modifier None Typical Low $26.92 Median $37.15 Typical High $53.70 | Professional | None | $26.92 | $37.15 | $53.70 |
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 $17.38 Median $21.38 Typical High $28.18 | Professional | 52 · Reduced service | $17.38 | $21.38 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $8.51 Typical High $11.22 | Professional | 53 · Discontinued | $6.92 | $8.51 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $6.46 Typical High $8.51 | Professional | 55 · Aftercare only | $5.25 | $6.46 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $4.27 Typical High $5.62 | Professional | 56 · Pre-op care only | $3.47 | $4.27 | $5.62 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | RR · Rental | $4.57 | $4.57 | $4.57 |
Where Kentucky sits
The same service costs 3.1 times more in Hawaii than in West Virginia. 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· 43rd of 51
$40.74
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.