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 $12.88 Median $21.88 Typical High $23.44 | Facility | None | $12.88 | $21.88 | $23.44 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $22.39 Typical High $23.99 | Professional | None | $12.88 | $22.39 | $23.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $26.30 Median $42.66 Typical High $44.67 | Facility | None | $26.30 | $42.66 | $44.67 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.18 Median $20.42 Typical High $28.18 | Professional | None | $13.18 | $20.42 | $28.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $10.00 Median $10.00 Typical High $15.14 | Professional | UE · Used equipment | $10.00 | $10.00 | $15.14 |
CareSource Setting Facility Modifier None Typical Low $26.92 Median $37.15 Typical High $60.26 | Facility | None | $26.92 | $37.15 | $60.26 |
CareSource Setting Professional Modifier None Typical Low $41.69 Median $52.48 Typical High $66.07 | Professional | None | $41.69 | $52.48 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $57.54 | Facility | None | $22.91 | $22.91 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $22.91 Typical High $204.17 | Professional | None | $16.98 | $22.91 | $204.17 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $32.36 | Professional | None | $26.92 | $26.92 | $32.36 |
United Setting Professional Modifier None Typical Low $13.80 Median $18.62 Typical High $27.54 | Professional | None | $13.80 | $18.62 | $27.54 |
4 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 $8.91 Median $11.22 Typical High $12.02 | Professional | 52 · Reduced service | $8.91 | $11.22 | $12.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $4.47 Typical High $4.79 | Professional | 53 · Discontinued | $3.55 | $4.47 | $4.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.63 Median $3.31 Typical High $3.63 | Professional | 55 · Aftercare only | $2.63 | $3.31 | $3.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $2.24 Typical High $2.40 | Professional | 56 · Pre-op care only | $1.78 | $2.24 | $2.40 |
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· 40th of 51
$20.42
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.