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 $10.47 Median $31.62 Typical High $33.11 | Facility | None | $10.47 | $31.62 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $32.36 Typical High $34.67 | Professional | None | $25.70 | $32.36 | $34.67 |
Anthem BCBS Setting Facility Modifier None Typical Low $38.02 Median $61.66 Typical High $64.57 | Facility | None | $38.02 | $61.66 | $64.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $28.18 Median $30.90 Typical High $40.74 | Professional | None | $28.18 | $30.90 | $40.74 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | UE · Used equipment | $23.44 | $23.44 | $23.44 |
CareSource Setting Facility Modifier None Typical Low $38.90 Median $53.70 Typical High $87.10 | Facility | None | $38.90 | $53.70 | $87.10 |
CareSource Setting Professional Modifier None Typical Low $60.26 Median $75.86 Typical High $95.50 | Professional | None | $60.26 | $75.86 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $83.18 | Facility | None | $33.11 | $33.11 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $33.11 Typical High $295.12 | Professional | None | $24.55 | $33.11 | $295.12 |
Molina Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $41.69 | Professional | None | $34.67 | $34.67 | $41.69 |
United Setting Professional Modifier None Typical Low $19.95 Median $26.92 Typical High $39.81 | Professional | None | $19.95 | $26.92 | $39.81 |
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 $12.88 Median $16.22 Typical High $17.38 | Professional | 52 · Reduced service | $12.88 | $16.22 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $6.46 Typical High $6.92 | Professional | 53 · Discontinued | $5.13 | $6.46 | $6.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $4.79 Typical High $5.25 | Professional | 55 · Aftercare only | $3.80 | $4.79 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $3.24 Typical High $3.47 | Professional | 56 · Pre-op care only | $2.51 | $3.24 | $3.47 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | RR · Rental | $3.16 | $3.16 | $3.16 |
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· 39th of 51
$30.90
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.