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 $25.12 Median $41.69 Typical High $43.65 | Facility | None | $25.12 | $41.69 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $41.69 Typical High $45.71 | Professional | None | $33.11 | $41.69 | $45.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $50.12 Median $79.43 Typical High $85.11 | Facility | None | $50.12 | $79.43 | $85.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $37.15 Median $40.74 Typical High $53.70 | Professional | None | $37.15 | $40.74 | $53.70 |
CareSource Setting Facility Modifier None Typical Low $51.29 Median $70.79 Typical High $114.82 | Facility | None | $51.29 | $70.79 | $114.82 |
CareSource Setting Professional Modifier None Typical Low $79.43 Median $97.72 Typical High $125.89 | Professional | None | $79.43 | $97.72 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $109.65 | Facility | None | $43.65 | $43.65 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $43.65 Typical High $380.19 | Professional | None | $31.62 | $43.65 | $380.19 |
Molina Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $61.66 | Professional | None | $51.29 | $51.29 | $61.66 |
United Setting Professional Modifier None Typical Low $26.30 Median $35.48 Typical High $51.29 | Professional | None | $26.30 | $35.48 | $51.29 |
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 $16.60 Median $20.89 Typical High $22.91 | Professional | 52 · Reduced service | $16.60 | $20.89 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $8.32 Typical High $9.12 | Professional | 53 · Discontinued | $6.61 | $8.32 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $6.31 Typical High $6.92 | Professional | 55 · Aftercare only | $5.01 | $6.31 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $4.17 Typical High $4.57 | Professional | 56 · Pre-op care only | $3.31 | $4.17 | $4.57 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | RR · Rental | $4.27 | $4.27 | $4.27 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $28.84 Median $31.62 Typical High $31.62 | Professional | UE · Used equipment | $28.84 | $31.62 | $31.62 |
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· 39th of 51
$40.74
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.