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 $17.78 Median $67.61 Typical High $70.79 | Facility | None | $17.78 | $67.61 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $67.61 Typical High $74.13 | Professional | None | $53.70 | $67.61 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $81.28 Median $131.83 Typical High $138.04 | Facility | None | $81.28 | $131.83 | $138.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $61.66 Typical High $87.10 | Professional | None | $60.26 | $61.66 | $87.10 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $46.77 Median $50.12 Typical High $50.12 | Professional | UE · Used equipment | $46.77 | $50.12 | $50.12 |
CareSource Setting Facility Modifier None Typical Low $83.18 Median $114.82 Typical High $186.21 | Facility | None | $83.18 | $114.82 | $186.21 |
CareSource Setting Professional Modifier None Typical Low $128.82 Median $158.49 Typical High $204.17 | Professional | None | $128.82 | $158.49 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $177.83 | Facility | None | $70.79 | $70.79 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $70.79 Typical High $616.60 | Professional | None | $51.29 | $70.79 | $616.60 |
Molina Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $89.13 | Professional | None | $74.13 | $74.13 | $89.13 |
United Setting Professional Modifier None Typical Low $42.66 Median $57.54 Typical High $85.11 | Professional | None | $42.66 | $57.54 | $85.11 |
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 $26.92 Median $33.88 Typical High $37.15 | Professional | 52 · Reduced service | $26.92 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $13.80 Typical High $14.79 | Professional | 53 · Discontinued | $10.96 | $13.80 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $10.23 Typical High $11.22 | Professional | 55 · Aftercare only | $8.13 | $10.23 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $6.76 Typical High $7.41 | Professional | 56 · Pre-op care only | $5.37 | $6.76 | $7.41 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | RR · Rental | $6.61 | $6.61 | $6.61 |
Where Kentucky sits
The same service costs 2.6 times more in Hawaii 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· 45th of 51
$63.10
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.