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 $21.88 Median $48.98 Typical High $51.29 | Facility | None | $21.88 | $48.98 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $48.98 Typical High $53.70 | Professional | None | $26.30 | $48.98 | $53.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $58.88 Median $93.33 Typical High $100.00 | Facility | None | $58.88 | $93.33 | $100.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $44.67 Typical High $63.10 | Professional | None | $43.65 | $44.67 | $63.10 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $36.31 Median $36.31 Typical High $47.86 | Professional | UE · Used equipment | $36.31 | $36.31 | $47.86 |
CareSource Setting Facility Modifier None Typical Low $60.26 Median $83.18 Typical High $134.90 | Facility | None | $60.26 | $83.18 | $134.90 |
CareSource Setting Professional Modifier None Typical Low $93.33 Median $114.82 Typical High $147.91 | Professional | None | $93.33 | $114.82 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $128.82 | Facility | None | $57.54 | $57.54 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $57.54 Typical High $446.68 | Professional | None | $41.69 | $57.54 | $446.68 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $64.57 | Professional | None | $53.70 | $53.70 | $64.57 |
United Setting Professional Modifier None Typical Low $30.90 Median $41.69 Typical High $60.26 | Professional | None | $30.90 | $41.69 | $60.26 |
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 $19.50 Median $24.55 Typical High $26.92 | Professional | 52 · Reduced service | $19.50 | $24.55 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $9.77 Typical High $10.72 | Professional | 53 · Discontinued | $7.76 | $9.77 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $7.41 Typical High $8.13 | Professional | 55 · Aftercare only | $5.89 | $7.41 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $4.90 Typical High $5.37 | Professional | 56 · Pre-op care only | $3.89 | $4.90 | $5.37 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | RR · Rental | $4.79 | $4.79 | $4.79 |
Where Kentucky sits
The same service costs 2.3 times more in Montana than in Florida. 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· 45th of 51
$45.71
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.