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 $9.77 Median $10.23 Typical High $18.20 | Facility | None | $9.77 | $10.23 | $18.20 |
Aetna Setting Professional Modifier None Typical Low $9.77 Median $10.23 Typical High $18.20 | Professional | None | $9.77 | $10.23 | $18.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $21.38 Median $50.12 Typical High $54.95 | Professional | None | $21.38 | $50.12 | $54.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | UE · Used equipment | $40.74 | $40.74 | $40.74 |
CareSource Setting Facility Modifier None Typical Low $83.18 Median $128.82 Typical High $239.88 | Facility | None | $83.18 | $128.82 | $239.88 |
CareSource Setting Professional Modifier None Typical Low $18.62 Median $25.70 Typical High $123.03 | Professional | None | $18.62 | $25.70 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $30.90 | Facility | None | $28.18 | $28.18 | $30.90 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $20.42 Typical High $104.71 | Professional | None | $18.20 | $20.42 | $104.71 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $100.00 | Professional | None | $95.50 | $95.50 | $100.00 |
United Setting Professional Modifier None Typical Low $9.33 Median $12.59 Typical High $18.20 | Professional | None | $9.33 | $12.59 | $18.20 |
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 $4.90 Median $5.13 Typical High $9.12 | Professional | 52 · Reduced service | $4.90 | $5.13 | $9.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.95 Median $2.04 Typical High $3.63 | Professional | 53 · Discontinued | $1.95 | $2.04 | $3.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.48 Median $1.55 Typical High $2.75 | Professional | 55 · Aftercare only | $1.48 | $1.55 | $2.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.98 Median $1.02 Typical High $1.82 | Professional | 56 · Pre-op care only | $0.98 | $1.02 | $1.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | RR · Rental | $5.50 | $5.50 | $5.50 |
Where Kentucky sits
The same service costs 8.7 times more in Hawaii 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· 5th of 51
$48.98
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.