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 $51.29 Median $52.48 Typical High $58.88 | Facility | None | $51.29 | $52.48 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $58.88 Typical High $70.79 | Professional | None | $51.29 | $58.88 | $70.79 |
Ambetter Setting Professional Modifier None Typical Low $74.13 Median $97.72 Typical High $97.72 | Professional | None | $74.13 | $97.72 | $97.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $60.26 Median $97.72 Typical High $102.33 | Facility | None | $60.26 | $97.72 | $102.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $57.54 Median $66.07 Typical High $75.86 | Professional | None | $57.54 | $66.07 | $75.86 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.62 Median $5.62 Typical High $6.61 | Professional | RR · Rental | $5.62 | $5.62 | $6.61 |
CareSource Setting Facility Modifier None Typical Low $72.44 Median $95.50 Typical High $138.04 | Facility | None | $72.44 | $95.50 | $138.04 |
CareSource Setting Professional Modifier None Typical Low $95.50 Median $104.71 Typical High $144.54 | Professional | None | $95.50 | $104.71 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $18.62 Median $66.07 Typical High $138.04 | Facility | None | $18.62 | $66.07 | $138.04 |
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 $44.67 Median $61.66 Typical High $501.19 | Professional | None | $44.67 | $61.66 | $501.19 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $89.13 | Professional | None | $75.86 | $75.86 | $89.13 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
United Setting Professional Modifier None Typical Low $32.36 Median $47.86 Typical High $75.86 | Professional | None | $32.36 | $47.86 | $75.86 |
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 $25.70 Median $28.18 Typical High $29.51 | Professional | 52 · Reduced service | $25.70 | $28.18 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $11.48 Typical High $11.75 | Professional | 53 · Discontinued | $10.23 | $11.48 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $8.51 Typical High $8.91 | Professional | 55 · Aftercare only | $7.59 | $8.51 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.75 Typical High $5.89 | Professional | 56 · Pre-op care only | $5.13 | $5.75 | $5.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $42.66 Typical High $48.98 | Professional | UE · Used equipment | $42.66 | $42.66 | $48.98 |
Where Kentucky sits
The same service costs 2.1 times more in Wisconsin than in New Jersey. 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· 30th of 51
$64.57
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.