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 $27.54 Median $40.74 Typical High $50.12 | Facility | None | $27.54 | $40.74 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $47.86 Typical High $53.70 | Professional | None | $33.88 | $47.86 | $53.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $47.86 Median $77.62 Typical High $81.28 | Facility | None | $47.86 | $77.62 | $81.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $35.48 Median $44.67 Typical High $51.29 | Professional | None | $35.48 | $44.67 | $51.29 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.57 Median $4.57 Typical High $45.71 | Professional | RR · Rental | $4.57 | $4.57 | $45.71 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $33.88 Median $33.88 Typical High $45.71 | Professional | UE · Used equipment | $33.88 | $33.88 | $45.71 |
CareSource Setting Facility Modifier None Typical Low $48.98 Median $69.18 Typical High $109.65 | Facility | None | $48.98 | $69.18 | $109.65 |
CareSource Setting Professional Modifier None Typical Low $75.86 Median $95.50 Typical High $123.03 | Professional | None | $75.86 | $95.50 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $123.03 | Facility | None | $54.95 | $54.95 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $54.95 Typical High $436.52 | Professional | None | $39.81 | $54.95 | $436.52 |
Molina Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $58.88 | Professional | None | $48.98 | $48.98 | $58.88 |
United Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
United Setting Professional Modifier None Typical Low $25.70 Median $38.02 Typical High $56.23 | Professional | None | $25.70 | $38.02 | $56.23 |
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 $16.98 Median $23.99 Typical High $26.92 | Professional | 52 · Reduced service | $16.98 | $23.99 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $9.55 Typical High $10.72 | Professional | 53 · Discontinued | $6.76 | $9.55 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $7.08 Typical High $7.94 | Professional | 55 · Aftercare only | $5.01 | $7.08 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $4.79 Typical High $5.37 | Professional | 56 · Pre-op care only | $3.39 | $4.79 | $5.37 |
Where Kentucky sits
The same service costs 3.5 times more in Hawaii than in West Virginia. 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· 41st of 51
$44.67
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.