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 $10.47 Median $18.62 Typical High $19.95 | Facility | None | $10.47 | $18.62 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $15.14 Median $19.05 Typical High $20.42 | Professional | None | $15.14 | $19.05 | $20.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $22.39 Median $36.31 Typical High $38.02 | Facility | None | $22.39 | $36.31 | $38.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.60 Median $18.62 Typical High $23.99 | Professional | None | $16.60 | $18.62 | $23.99 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $13.80 Median $13.80 Typical High $18.62 | Professional | UE · Used equipment | $13.80 | $13.80 | $18.62 |
CareSource Setting Facility Modifier None Typical Low $22.91 Median $31.62 Typical High $51.29 | Facility | None | $22.91 | $31.62 | $51.29 |
CareSource Setting Professional Modifier None Typical Low $35.48 Median $44.67 Typical High $56.23 | Professional | None | $35.48 | $44.67 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $48.98 | Facility | None | $24.55 | $24.55 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $24.55 Typical High $173.78 | Professional | None | $17.78 | $24.55 | $173.78 |
Molina Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $24.55 | Professional | None | $20.42 | $20.42 | $24.55 |
United Setting Professional Modifier None Typical Low $11.75 Median $15.85 Typical High $23.44 | Professional | None | $11.75 | $15.85 | $23.44 |
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 $7.59 Median $9.55 Typical High $10.23 | Professional | 52 · Reduced service | $7.59 | $9.55 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $3.80 Typical High $4.17 | Professional | 53 · Discontinued | $3.02 | $3.80 | $4.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $2.82 Typical High $3.09 | Professional | 55 · Aftercare only | $2.24 | $2.82 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $1.91 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.51 | $1.91 | $2.04 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.82 Median $1.82 Typical High $2.51 | Professional | RR · Rental | $1.82 | $1.82 | $2.51 |
Where Kentucky sits
The same service costs 2.1 times more in Montana than in West Virginia. 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
$18.62
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.