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 $15.14 Median $17.78 Typical High $17.78 | Facility | None | $15.14 | $17.78 | $17.78 |
Aetna Setting Professional Modifier None Typical Low $15.14 Median $17.78 Typical High $17.78 | Professional | None | $15.14 | $17.78 | $17.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $35.48 Median $66.07 Typical High $75.86 | Professional | None | $35.48 | $66.07 | $75.86 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | RR · Rental | $6.61 | $6.61 | $6.61 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | UE · Used equipment | $48.98 | $48.98 | $48.98 |
CareSource Setting Facility Modifier None Typical Low $131.83 Median $181.97 Typical High $295.12 | Facility | None | $131.83 | $181.97 | $295.12 |
CareSource Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $323.59 | Professional | None | $190.55 | $239.88 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $64.57 | Facility | None | $10.72 | $10.72 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $10.72 | Professional | None | $7.76 | $7.76 | $10.72 |
Molina Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $154.88 | Professional | None | $147.91 | $147.91 | $154.88 |
United Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
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 $7.59 Median $8.91 Typical High $8.91 | Professional | 52 · Reduced service | $7.59 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $3.55 Typical High $3.55 | Professional | 53 · Discontinued | $3.02 | $3.55 | $3.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $2.69 Typical High $2.69 | Professional | 55 · Aftercare only | $2.24 | $2.69 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $1.78 Typical High $1.78 | Professional | 56 · Pre-op care only | $1.51 | $1.78 | $1.78 |
Where Kentucky sits
The same service costs 27.5 times more in Kansas than in South Carolina. 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· 8th of 51
$66.07
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.