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 $13.18 Median $32.36 Typical High $34.67 | Facility | None | $13.18 | $32.36 | $34.67 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $32.36 Typical High $36.31 | Professional | None | $17.78 | $32.36 | $36.31 |
Ambetter Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Anthem BCBS Setting Facility Modifier None Typical Low $38.90 Median $63.10 Typical High $66.07 | Facility | None | $38.90 | $63.10 | $66.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $28.84 Median $30.20 Typical High $41.69 | Professional | None | $28.84 | $30.20 | $41.69 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $25.12 Median $25.12 Typical High $34.67 | Professional | UE · Used equipment | $25.12 | $25.12 | $34.67 |
CareSource Setting Facility Modifier None Typical Low $39.81 Median $54.95 Typical High $89.13 | Facility | None | $39.81 | $54.95 | $89.13 |
CareSource Setting Professional Modifier None Typical Low $61.66 Median $77.62 Typical High $97.72 | Professional | None | $61.66 | $77.62 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $36.31 Typical High $85.11 | Facility | None | $33.88 | $36.31 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $33.88 Typical High $302.00 | Professional | None | $25.12 | $33.88 | $302.00 |
Molina Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $41.69 | Professional | None | $34.67 | $34.67 | $41.69 |
United Setting Professional Modifier None Typical Low $20.42 Median $27.54 Typical High $40.74 | Professional | None | $20.42 | $27.54 | $40.74 |
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 $13.18 Median $16.60 Typical High $17.78 | Professional | 52 · Reduced service | $13.18 | $16.60 | $17.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $6.61 Typical High $7.24 | Professional | 53 · Discontinued | $5.25 | $6.61 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $4.90 Typical High $5.37 | Professional | 55 · Aftercare only | $3.89 | $4.90 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $3.31 Typical High $3.63 | Professional | 56 · Pre-op care only | $2.63 | $3.31 | $3.63 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.31 Median $3.31 Typical High $3.31 | Professional | RR · Rental | $3.31 | $3.31 | $3.31 |
Where Kentucky sits
The same service costs 2.8 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· 46th of 51
$30.20
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.