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 $17.78 Median $30.20 Typical High $31.62 | Facility | None | $17.78 | $30.20 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $30.20 Typical High $33.11 | Professional | None | $25.12 | $30.20 | $33.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $36.31 Median $57.54 Typical High $61.66 | Facility | None | $36.31 | $57.54 | $61.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.92 Median $30.90 Typical High $39.81 | Professional | None | $26.92 | $30.90 | $39.81 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | RR · Rental | $3.09 | $3.09 | $3.09 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | UE · Used equipment | $22.91 | $22.91 | $22.91 |
CareSource Setting Facility Modifier None Typical Low $37.15 Median $51.29 Typical High $83.18 | Facility | None | $37.15 | $51.29 | $83.18 |
CareSource Setting Professional Modifier None Typical Low $57.54 Median $70.79 Typical High $91.20 | Professional | None | $57.54 | $70.79 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $79.43 | Facility | None | $33.11 | $33.11 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $33.11 Typical High $275.42 | Professional | None | $23.99 | $33.11 | $275.42 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $38.02 | Professional | None | $32.36 | $32.36 | $38.02 |
United Setting Professional Modifier None Typical Low $19.05 Median $25.70 Typical High $38.02 | Professional | None | $19.05 | $25.70 | $38.02 |
4 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 $12.02 Median $15.14 Typical High $16.60 | Professional | 52 · Reduced service | $12.02 | $15.14 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $6.03 Typical High $6.61 | Professional | 53 · Discontinued | $4.79 | $6.03 | $6.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $4.57 Typical High $5.01 | Professional | 55 · Aftercare only | $3.63 | $4.57 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $3.02 Typical High $3.31 | Professional | 56 · Pre-op care only | $2.40 | $3.02 | $3.31 |
Where Kentucky sits
The same service costs 2.6 times more in Montana than in Kansas. 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· 37th of 51
$30.90
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.