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 $1,174.90 Median $2,089.30 Typical High $2,089.30 | Facility | None | $1,174.90 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $2,089.30 Typical High $2,754.23 | Professional | None | $1,479.11 | $2,089.30 | $2,754.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,511.89 Median $3,981.07 Typical High $4,168.69 | Facility | None | $2,511.89 | $3,981.07 | $4,168.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,819.70 Median $1,905.46 Typical High $2,691.53 | Professional | None | $1,819.70 | $1,905.46 | $2,691.53 |
CareSource Setting Facility Modifier None Typical Low $2,570.40 Median $3,548.13 Typical High $5,754.40 | Facility | None | $2,570.40 | $3,548.13 | $5,754.40 |
CareSource Setting Professional Modifier None Typical Low $3,890.45 Median $4,897.79 Typical High $6,309.57 | Professional | None | $3,890.45 | $4,897.79 | $6,309.57 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $5,495.41 | Facility | None | $1,995.26 | $1,995.26 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,995.26 Typical High $18,197.01 | Professional | None | $1,479.11 | $1,995.26 | $18,197.01 |
Molina Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,019.95 | Professional | None | $2,511.89 | $2,511.89 | $3,019.95 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,951.21 | Facility | None | $2,137.96 | $2,137.96 | $2,951.21 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,778.28 Typical High $2,570.40 | Professional | None | $1,230.27 | $1,778.28 | $2,570.40 |
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 $741.31 Median $1,047.13 Typical High $1,380.38 | Professional | 52 · Reduced service | $741.31 | $1,047.13 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $416.87 Typical High $549.54 | Professional | 53 · Discontinued | $295.12 | $416.87 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $309.03 Typical High $416.87 | Professional | 55 · Aftercare only | $218.78 | $309.03 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $208.93 Typical High $275.42 | Professional | 56 · Pre-op care only | $147.91 | $208.93 | $275.42 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | RR · Rental | $194.98 | $194.98 | $194.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | UE · Used equipment | $1,479.11 | $1,479.11 | $1,479.11 |
Where Kentucky sits
The same service costs 4.4 times more in Hawaii 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· 38th of 51
$1,905
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.