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 $5.75 Median $26.92 Typical High $28.18 | Facility | None | $5.75 | $26.92 | $28.18 |
Aetna Setting Professional Modifier None Typical Low $14.45 Median $26.92 Typical High $29.51 | Professional | None | $14.45 | $26.92 | $29.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $32.36 Median $51.29 Typical High $54.95 | Facility | None | $32.36 | $51.29 | $54.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $23.99 Median $26.30 Typical High $34.67 | Professional | None | $23.99 | $26.30 | $34.67 |
CareSource Setting Facility Modifier None Typical Low $33.11 Median $45.71 Typical High $74.13 | Facility | None | $33.11 | $45.71 | $74.13 |
CareSource Setting Professional Modifier None Typical Low $51.29 Median $63.10 Typical High $81.28 | Professional | None | $51.29 | $63.10 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $70.79 | Facility | None | $33.88 | $33.88 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $33.88 Typical High $245.47 | Professional | None | $24.55 | $33.88 | $245.47 |
Molina Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $36.31 | Professional | None | $30.90 | $30.90 | $36.31 |
United Setting Professional Modifier None Typical Low $16.98 Median $22.91 Typical High $33.88 | Professional | None | $16.98 | $22.91 | $33.88 |
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 $10.72 Median $13.49 Typical High $14.79 | Professional | 52 · Reduced service | $10.72 | $13.49 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $5.37 Typical High $5.89 | Professional | 53 · Discontinued | $4.27 | $5.37 | $5.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $4.07 Typical High $4.47 | Professional | 55 · Aftercare only | $3.24 | $4.07 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.69 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.14 | $2.69 | $2.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.75 Median $2.75 Typical High $2.75 | Professional | RR · Rental | $2.75 | $2.75 | $2.75 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | UE · Used equipment | $20.42 | $20.42 | $20.42 |
Where Kentucky sits
The same service costs 2.2 times more in Montana than in Arizona. 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
$26.30
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.