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 $38.90 Median $58.88 Typical High $58.88 | Facility | None | $38.90 | $58.88 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $58.88 Typical High $77.62 | Professional | None | $38.90 | $58.88 | $77.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $69.18 Median $112.20 Typical High $117.49 | Facility | None | $69.18 | $112.20 | $117.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $51.29 Median $61.66 Typical High $74.13 | Professional | None | $51.29 | $61.66 | $74.13 |
CareSource Setting Facility Modifier None Typical Low $70.79 Median $100.00 Typical High $158.49 | Facility | None | $70.79 | $100.00 | $158.49 |
CareSource Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $177.83 | Professional | None | $109.65 | $138.04 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $173.78 | Facility | None | $69.18 | $69.18 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $69.18 Typical High $630.96 | Professional | None | $50.12 | $69.18 | $630.96 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $83.18 | Professional | None | $70.79 | $70.79 | $83.18 |
United Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $83.18 | Facility | None | $70.79 | $70.79 | $83.18 |
United Setting Professional Modifier None Typical Low $36.31 Median $51.29 Typical High $72.44 | Professional | None | $36.31 | $51.29 | $72.44 |
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 $23.99 Median $28.84 Typical High $38.90 | Professional | 52 · Reduced service | $23.99 | $28.84 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $11.75 Typical High $15.49 | Professional | 53 · Discontinued | $9.55 | $11.75 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $8.71 Typical High $11.48 | Professional | 55 · Aftercare only | $7.24 | $8.71 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.89 Typical High $7.76 | Professional | 56 · Pre-op care only | $4.79 | $5.89 | $7.76 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | RR · Rental | $6.46 | $6.46 | $6.46 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | UE · Used equipment | $47.86 | $47.86 | $47.86 |
Where Kentucky sits
The same service costs 4.4 times more in Hawaii 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
$61.66
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.