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 $56.23 Median $61.66 Typical High $64.57 | Facility | None | $56.23 | $61.66 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $61.66 Typical High $67.61 | Professional | None | $56.23 | $61.66 | $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 $67.61 Median $79.43 Typical High $91.20 | Professional | None | $67.61 | $79.43 | $91.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.61 Median $6.61 Typical High $6.92 | Professional | RR · Rental | $6.61 | $6.61 | $6.92 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $50.12 Median $50.12 Typical High $53.70 | Professional | UE · Used equipment | $50.12 | $50.12 | $53.70 |
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 $13.49 Median $70.79 Typical High $162.18 | Facility | None | $13.49 | $70.79 | $162.18 |
Cigna Setting Facility Modifier RR · Rental Typical Low $9.77 Median $45.71 Typical High $64.57 | Facility | RR · Rental | $9.77 | $45.71 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $70.79 Typical High $562.34 | Professional | None | $51.29 | $70.79 | $562.34 |
Molina Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $109.65 | Professional | None | $91.20 | $91.20 | $109.65 |
United Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $63.10 | Facility | None | $57.54 | $57.54 | $63.10 |
United Setting Professional Modifier None Typical Low $38.90 Median $54.95 Typical High $85.11 | Professional | None | $38.90 | $54.95 | $85.11 |
4 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 $28.18 Median $30.90 Typical High $33.88 | Professional | 52 · Reduced service | $28.18 | $30.90 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.30 Typical High $12.88 | Professional | 53 · Discontinued | $12.02 | $12.30 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $9.33 Typical High $10.23 | Professional | 55 · Aftercare only | $8.51 | $9.33 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.17 Typical High $6.76 | Professional | 56 · Pre-op care only | $5.62 | $6.17 | $6.76 |
Where Kentucky sits
The same service costs 2.4 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· 24th of 51
$70.79
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.