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 $10.23 Median $27.54 Typical High $29.51 | Facility | None | $10.23 | $27.54 | $29.51 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $28.18 Typical High $30.20 | Professional | None | $22.39 | $28.18 | $30.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $33.11 Median $53.70 Typical High $56.23 | Facility | None | $33.11 | $53.70 | $56.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $24.55 Median $27.54 Typical High $37.15 | Professional | None | $24.55 | $27.54 | $37.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.75 Median $2.75 Typical High $2.75 | Professional | RR · Rental | $2.75 | $2.75 | $2.75 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | UE · Used equipment | $20.42 | $20.42 | $20.42 |
CareSource Setting Facility Modifier None Typical Low $33.88 Median $46.77 Typical High $75.86 | Facility | None | $33.88 | $46.77 | $75.86 |
CareSource Setting Professional Modifier None Typical Low $52.48 Median $66.07 Typical High $83.18 | Professional | None | $52.48 | $66.07 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $72.44 | Facility | None | $34.67 | $34.67 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $34.67 Typical High $257.04 | Professional | None | $25.70 | $34.67 | $257.04 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $36.31 | Professional | None | $30.20 | $30.20 | $36.31 |
United Setting Professional Modifier None Typical Low $17.38 Median $23.44 Typical High $34.67 | Professional | None | $17.38 | $23.44 | $34.67 |
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 $11.22 Median $14.13 Typical High $15.14 | Professional | 52 · Reduced service | $11.22 | $14.13 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $5.62 Typical High $6.17 | Professional | 53 · Discontinued | $4.47 | $5.62 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $4.17 Typical High $4.57 | Professional | 55 · Aftercare only | $3.31 | $4.17 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $2.82 Typical High $3.02 | Professional | 56 · Pre-op care only | $2.24 | $2.82 | $3.02 |
Where Kentucky sits
The same service costs 2.1 times more in Montana 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· 36th of 51
$27.54
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.