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 $7.59 Median $26.30 Typical High $27.54 | Facility | None | $7.59 | $26.30 | $27.54 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $26.30 Typical High $28.84 | Professional | None | $20.89 | $26.30 | $28.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $31.62 Median $50.12 Typical High $52.48 | Facility | None | $31.62 | $50.12 | $52.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $22.91 Median $25.70 Typical High $33.11 | Professional | None | $22.91 | $25.70 | $33.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $19.95 Median $19.95 Typical High $26.92 | Professional | UE · Used equipment | $19.95 | $19.95 | $26.92 |
CareSource Setting Facility Modifier None Typical Low $32.36 Median $44.67 Typical High $70.79 | Facility | None | $32.36 | $44.67 | $70.79 |
CareSource Setting Professional Modifier None Typical Low $48.98 Median $61.66 Typical High $79.43 | Professional | None | $48.98 | $61.66 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $69.18 | Facility | None | $27.54 | $27.54 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $27.54 Typical High $239.88 | Professional | None | $19.95 | $27.54 | $239.88 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $38.02 | Professional | None | $32.36 | $32.36 | $38.02 |
United Setting Professional Modifier None Typical Low $16.22 Median $22.39 Typical High $32.36 | Professional | None | $16.22 | $22.39 | $32.36 |
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 $10.47 Median $13.18 Typical High $14.45 | Professional | 52 · Reduced service | $10.47 | $13.18 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $5.25 Typical High $5.75 | Professional | 53 · Discontinued | $4.17 | $5.25 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.98 Typical High $4.27 | Professional | 55 · Aftercare only | $3.16 | $3.98 | $4.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.63 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.09 | $2.63 | $2.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | RR · Rental | $2.69 | $2.69 | $2.69 |
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· 37th of 51
$25.70
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.