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 $18.62 Median $54.95 Typical High $57.54 | Facility | None | $18.62 | $54.95 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $54.95 Typical High $60.26 | Professional | None | $43.65 | $54.95 | $60.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $66.07 Median $104.71 Typical High $109.65 | Facility | None | $66.07 | $104.71 | $109.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $53.70 Typical High $69.18 | Professional | None | $47.86 | $53.70 | $69.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $39.81 Median $40.74 Typical High $40.74 | Professional | UE · Used equipment | $39.81 | $40.74 | $40.74 |
CareSource Setting Facility Modifier None Typical Low $67.61 Median $93.33 Typical High $151.36 | Facility | None | $67.61 | $93.33 | $151.36 |
CareSource Setting Professional Modifier None Typical Low $102.33 Median $128.82 Typical High $165.96 | Professional | None | $102.33 | $128.82 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $144.54 | Facility | None | $57.54 | $57.54 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $57.54 Typical High $501.19 | Professional | None | $41.69 | $57.54 | $501.19 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $72.44 | Professional | None | $60.26 | $60.26 | $72.44 |
United Setting Professional Modifier None Typical Low $34.67 Median $46.77 Typical High $67.61 | Professional | None | $34.67 | $46.77 | $67.61 |
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 $21.88 Median $27.54 Typical High $30.20 | Professional | 52 · Reduced service | $21.88 | $27.54 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $10.96 Typical High $12.02 | Professional | 53 · Discontinued | $8.71 | $10.96 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $8.32 Typical High $9.12 | Professional | 55 · Aftercare only | $6.61 | $8.32 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.50 Typical High $6.03 | Professional | 56 · Pre-op care only | $4.37 | $5.50 | $6.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | RR · Rental | $5.37 | $5.37 | $5.37 |
Where Kentucky sits
The same service costs 2.6 times more in Montana than in Delaware. 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· 35th of 51
$53.70
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.