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 $15.49 Median $16.60 Typical High $28.84 | Facility | None | $15.49 | $16.60 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $15.49 Median $16.60 Typical High $28.84 | Professional | None | $15.49 | $16.60 | $28.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.88 Median $53.70 Typical High $54.95 | Professional | None | $33.88 | $53.70 | $54.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.01 Median $5.01 Typical High $50.12 | Professional | RR · Rental | $5.01 | $5.01 | $50.12 |
CareSource Setting Facility Modifier None Typical Low $70.79 Median $107.15 Typical High $199.53 | Facility | None | $70.79 | $107.15 | $199.53 |
CareSource Setting Professional Modifier None Typical Low $32.36 Median $41.69 Typical High $102.33 | Professional | None | $32.36 | $41.69 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $46.77 | Facility | None | $30.20 | $30.20 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $28.84 Typical High $165.96 | Professional | None | $21.88 | $28.84 | $165.96 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $83.18 | Professional | None | $79.43 | $79.43 | $83.18 |
United Setting Professional Modifier None Typical Low $15.14 Median $19.95 Typical High $28.84 | Professional | None | $15.14 | $19.95 | $28.84 |
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 $7.76 Median $8.32 Typical High $14.45 | Professional | 52 · Reduced service | $7.76 | $8.32 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $3.31 Typical High $5.75 | Professional | 53 · Discontinued | $3.16 | $3.31 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $2.45 Typical High $4.37 | Professional | 55 · Aftercare only | $2.34 | $2.45 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $1.66 Typical High $2.88 | Professional | 56 · Pre-op care only | $1.55 | $1.66 | $2.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | UE · Used equipment | $38.02 | $38.02 | $38.02 |
Where Kentucky sits
The same service costs 6.5 times more in Kansas than in Hawaii. 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· 6th of 51
$50.12
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.