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 $22.39 Median $39.81 Typical High $41.69 | Facility | None | $22.39 | $39.81 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $40.74 Typical High $43.65 | Professional | None | $32.36 | $40.74 | $43.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $47.86 Median $77.62 Typical High $81.28 | Facility | None | $47.86 | $77.62 | $81.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $35.48 Median $38.90 Typical High $51.29 | Professional | None | $35.48 | $38.90 | $51.29 |
CareSource Setting Facility Modifier None Typical Low $48.98 Median $67.61 Typical High $109.65 | Facility | None | $48.98 | $67.61 | $109.65 |
CareSource Setting Professional Modifier None Typical Low $75.86 Median $93.33 Typical High $120.23 | Professional | None | $75.86 | $93.33 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $104.71 | Facility | None | $41.69 | $41.69 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $41.69 Typical High $363.08 | Professional | None | $30.90 | $41.69 | $363.08 |
Molina Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $52.48 | Professional | None | $43.65 | $43.65 | $52.48 |
United Setting Professional Modifier None Typical Low $25.12 Median $33.88 Typical High $50.12 | Professional | None | $25.12 | $33.88 | $50.12 |
6 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 $15.85 Median $19.95 Typical High $21.88 | Professional | 52 · Reduced service | $15.85 | $19.95 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $8.13 Typical High $8.71 | Professional | 53 · Discontinued | $6.46 | $8.13 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $6.03 Typical High $6.61 | Professional | 55 · Aftercare only | $4.79 | $6.03 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $4.07 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.24 | $4.07 | $4.37 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | RR · Rental | $4.07 | $4.07 | $4.07 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $27.54 Median $30.90 Typical High $30.90 | Professional | UE · Used equipment | $27.54 | $30.90 | $30.90 |
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· 41st of 51
$38.90
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.