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 $79.43 Median $112.20 Typical High $117.49 | Facility | None | $79.43 | $112.20 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $112.20 Typical High $123.03 | Professional | None | $93.33 | $112.20 | $123.03 |
Ambetter Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $134.90 Median $213.80 Typical High $223.87 | Facility | None | $134.90 | $213.80 | $223.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $97.72 Typical High $144.54 | Professional | None | $61.66 | $97.72 | $144.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $85.11 Median $85.11 Typical High $91.20 | Professional | UE · Used equipment | $85.11 | $85.11 | $91.20 |
CareSource Setting Facility Modifier None Typical Low $138.04 Median $190.55 Typical High $309.03 | Facility | None | $138.04 | $190.55 | $309.03 |
CareSource Setting Professional Modifier None Typical Low $208.93 Median $263.03 Typical High $338.84 | Professional | None | $208.93 | $263.03 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $295.12 | Facility | None | $141.25 | $141.25 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $141.25 Typical High $1,023.29 | Professional | None | $102.33 | $141.25 | $1,023.29 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $147.91 | Professional | None | $123.03 | $123.03 | $147.91 |
United Setting Professional Modifier None Typical Low $70.79 Median $95.50 Typical High $138.04 | Professional | None | $70.79 | $95.50 | $138.04 |
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 $44.67 Median $56.23 Typical High $61.66 | Professional | 52 · Reduced service | $44.67 | $56.23 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $22.39 Typical High $24.55 | Professional | 53 · Discontinued | $17.78 | $22.39 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $16.98 Typical High $18.62 | Professional | 55 · Aftercare only | $13.49 | $16.98 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $11.22 Typical High $12.30 | Professional | 56 · Pre-op care only | $8.91 | $11.22 | $12.30 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.48 Median $11.48 Typical High $12.30 | Professional | RR · Rental | $11.48 | $11.48 | $12.30 |
Where Kentucky sits
The same service costs 2.0 times more in Wyoming than in New Jersey. 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· 45th of 51
$105
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.