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 $9.77 Median $20.42 Typical High $21.38 | Facility | None | $9.77 | $20.42 | $21.38 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $20.42 Typical High $22.39 | Professional | None | $16.22 | $20.42 | $22.39 |
Anthem BCBS Setting Facility Modifier None Typical Low $24.55 Median $38.90 Typical High $41.69 | Facility | None | $24.55 | $38.90 | $41.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.20 Median $20.89 Typical High $26.92 | Professional | None | $18.20 | $20.89 | $26.92 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | RR · Rental | $2.04 | $2.04 | $2.04 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | UE · Used equipment | $15.49 | $15.49 | $15.49 |
CareSource Setting Facility Modifier None Typical Low $25.12 Median $34.67 Typical High $56.23 | Facility | None | $25.12 | $34.67 | $56.23 |
CareSource Setting Professional Modifier None Typical Low $38.90 Median $47.86 Typical High $61.66 | Professional | None | $38.90 | $47.86 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $53.70 | Facility | None | $21.38 | $21.38 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $21.38 Typical High $186.21 | Professional | None | $15.49 | $21.38 | $186.21 |
Molina Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
United Setting Professional Modifier None Typical Low $12.88 Median $17.38 Typical High $25.12 | Professional | None | $12.88 | $17.38 | $25.12 |
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 $8.13 Median $10.23 Typical High $11.22 | Professional | 52 · Reduced service | $8.13 | $10.23 | $11.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $4.07 Typical High $4.47 | Professional | 53 · Discontinued | $3.24 | $4.07 | $4.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $3.09 Typical High $3.39 | Professional | 55 · Aftercare only | $2.45 | $3.09 | $3.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $2.04 Typical High $2.24 | Professional | 56 · Pre-op care only | $1.62 | $2.04 | $2.24 |
Where Kentucky sits
The same service costs 3.1 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· 34th of 51
$20.89
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.