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 $102.33 Median $199.53 Typical High $213.80 | Facility | None | $102.33 | $199.53 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $204.17 Typical High $234.42 | Professional | None | $169.82 | $204.17 | $234.42 |
Ambetter Setting Professional Modifier None Typical Low $309.03 Median $389.05 Typical High $389.05 | Professional | None | $309.03 | $389.05 | $389.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $239.88 Median $389.05 Typical High $407.38 | Facility | None | $239.88 | $389.05 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $109.65 Median $177.83 Typical High $257.04 | Professional | None | $109.65 | $177.83 | $257.04 |
CareSource Setting Facility Modifier None Typical Low $288.40 Median $380.19 Typical High $549.54 | Facility | None | $288.40 | $380.19 | $549.54 |
CareSource Setting Professional Modifier None Typical Low $380.19 Median $416.87 Typical High $575.44 | Professional | None | $380.19 | $416.87 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $524.81 | Facility | None | $208.93 | $208.93 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $208.93 Typical High $1,862.09 | Professional | None | $154.88 | $208.93 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $295.12 | Professional | None | $245.47 | $245.47 | $295.12 |
United Setting Professional Modifier None Typical Low $125.89 Median $169.82 Typical High $251.19 | Professional | None | $125.89 | $169.82 | $251.19 |
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 $81.28 Median $102.33 Typical High $109.65 | Professional | 52 · Reduced service | $81.28 | $102.33 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $40.74 Typical High $44.67 | Professional | 53 · Discontinued | $32.36 | $40.74 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $30.20 Typical High $33.11 | Professional | 55 · Aftercare only | $23.99 | $30.20 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $20.42 Typical High $22.39 | Professional | 56 · Pre-op care only | $16.22 | $20.42 | $22.39 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | RR · Rental | $21.88 | $21.88 | $21.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | UE · Used equipment | $165.96 | $165.96 | $165.96 |
Where Kentucky sits
The same service costs 2.4 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· 38th of 51
$200
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.