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 $5.62 Median $5.89 Typical High $10.23 | Facility | None | $5.62 | $5.89 | $10.23 |
Aetna Setting Professional Modifier None Typical Low $5.62 Median $6.17 Typical High $10.23 | Professional | None | $5.62 | $6.17 | $10.23 |
Ambetter Setting Professional Modifier None Typical Low $13.18 Median $15.49 Typical High $15.49 | Professional | None | $13.18 | $15.49 | $15.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.30 Median $14.45 Typical High $21.88 | Professional | None | $12.30 | $14.45 | $21.88 |
CareSource Setting Facility Modifier None Typical Low $10.47 Median $14.79 Typical High $22.39 | Facility | None | $10.47 | $14.79 | $22.39 |
CareSource Setting Professional Modifier None Typical Low $10.47 Median $12.59 Typical High $16.98 | Professional | None | $10.47 | $12.59 | $16.98 |
Cigna Setting Facility Modifier None Typical Low $16.60 Median $20.89 Typical High $23.44 | Facility | None | $16.60 | $20.89 | $23.44 |
Cigna Setting Professional Modifier None Typical Low $10.00 Median $15.49 Typical High $60.26 | Professional | None | $10.00 | $15.49 | $60.26 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $22.91 | Professional | None | $21.88 | $21.88 | $22.91 |
United Setting Professional Modifier None Typical Low $5.37 Median $7.08 Typical High $10.23 | Professional | None | $5.37 | $7.08 | $10.23 |
6 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 $2.75 Median $2.95 Typical High $5.13 | Professional | 52 · Reduced service | $2.75 | $2.95 | $5.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.12 Median $1.17 Typical High $2.04 | Professional | 53 · Discontinued | $1.12 | $1.17 | $2.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.83 Median $0.87 Typical High $1.55 | Professional | 55 · Aftercare only | $0.83 | $0.87 | $1.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.59 Typical High $1.05 | Professional | 56 · Pre-op care only | $0.56 | $0.59 | $1.05 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.41 Median $1.41 Typical High $1.41 | Professional | RR · Rental | $1.41 | $1.41 | $1.41 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | UE · Used equipment | $10.72 | $10.72 | $10.72 |
Where Kentucky sits
The same service costs 6.2 times more in Wyoming than in North 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· 28th of 51
$14.13
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.