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 $7.76 Median $47.86 Typical High $50.12 | Facility | None | $7.76 | $47.86 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $47.86 Typical High $52.48 | Professional | None | $25.70 | $47.86 | $52.48 |
Ambetter Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | None | $6.03 | $6.03 | $6.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $56.23 Median $91.20 Typical High $95.50 | Facility | None | $56.23 | $91.20 | $95.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $41.69 Median $43.65 Typical High $60.26 | Professional | None | $41.69 | $43.65 | $60.26 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $32.36 Median $34.67 Typical High $34.67 | Professional | UE · Used equipment | $32.36 | $34.67 | $34.67 |
CareSource Setting Facility Modifier None Typical Low $57.54 Median $81.28 Typical High $128.82 | Facility | None | $57.54 | $81.28 | $128.82 |
CareSource Setting Professional Modifier None Typical Low $89.13 Median $112.20 Typical High $144.54 | Professional | None | $89.13 | $112.20 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $123.03 | Facility | None | $50.12 | $50.12 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $50.12 Typical High $436.52 | Professional | None | $36.31 | $50.12 | $436.52 |
Molina Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $61.66 | Professional | None | $51.29 | $51.29 | $61.66 |
United Setting Professional Modifier None Typical Low $29.51 Median $39.81 Typical High $58.88 | Professional | None | $29.51 | $39.81 | $58.88 |
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 $19.05 Median $23.99 Typical High $26.30 | Professional | 52 · Reduced service | $19.05 | $23.99 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $9.55 Typical High $10.47 | Professional | 53 · Discontinued | $7.59 | $9.55 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $7.08 Typical High $7.76 | Professional | 55 · Aftercare only | $5.75 | $7.08 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $4.79 Typical High $5.25 | Professional | 56 · Pre-op care only | $3.80 | $4.79 | $5.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | RR · Rental | $4.68 | $4.68 | $4.68 |
Where Kentucky sits
The same service costs 3.0 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· 44th of 51
$43.65
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.