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 $61.66 Median $61.66 Typical High $64.57 | Facility | None | $61.66 | $61.66 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $64.57 Typical High $67.61 | Professional | None | $57.54 | $64.57 | $67.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $74.13 Median $117.49 Typical High $125.89 | Facility | None | $74.13 | $117.49 | $125.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $56.23 Typical High $79.43 | Professional | None | $54.95 | $56.23 | $79.43 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | UE · Used equipment | $46.77 | $46.77 | $46.77 |
CareSource Setting Facility Modifier None Typical Low $75.86 Median $104.71 Typical High $169.82 | Facility | None | $75.86 | $104.71 | $169.82 |
CareSource Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $186.21 | Professional | None | $117.49 | $144.54 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $162.18 | Facility | None | $64.57 | $64.57 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $64.57 Typical High $562.34 | Professional | None | $46.77 | $64.57 | $562.34 |
Molina Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $74.13 | Professional | None | $61.66 | $61.66 | $74.13 |
United Setting Professional Modifier None Typical Low $38.90 Median $52.48 Typical High $77.62 | Professional | None | $38.90 | $52.48 | $77.62 |
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 $28.84 Median $32.36 Typical High $33.88 | Professional | 52 · Reduced service | $28.84 | $32.36 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $12.88 Typical High $13.49 | Professional | 53 · Discontinued | $11.48 | $12.88 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $9.77 Typical High $10.23 | Professional | 55 · Aftercare only | $8.51 | $9.77 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.46 Typical High $6.76 | Professional | 56 · Pre-op care only | $5.75 | $6.46 | $6.76 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | RR · Rental | $6.31 | $6.31 | $6.31 |
Where Kentucky sits
The same service costs 2.6 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· 46th of 51
$57.54
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.