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 $46.77 Median $48.98 Typical High $56.23 | Facility | None | $46.77 | $48.98 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $53.70 Typical High $64.57 | Professional | None | $46.77 | $53.70 | $64.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $58.88 Median $95.50 Typical High $100.00 | Facility | None | $58.88 | $95.50 | $100.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $63.10 Typical High $72.44 | Professional | None | $50.12 | $63.10 | $72.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.01 Median $5.01 Typical High $5.75 | Professional | RR · Rental | $5.01 | $5.01 | $5.75 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $38.02 Median $38.02 Typical High $43.65 | Professional | UE · Used equipment | $38.02 | $38.02 | $43.65 |
CareSource Setting Facility Modifier None Typical Low $60.26 Median $83.18 Typical High $134.90 | Facility | None | $60.26 | $83.18 | $134.90 |
CareSource Setting Professional Modifier None Typical Low $93.33 Median $114.82 Typical High $147.91 | Professional | None | $93.33 | $114.82 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $12.88 Median $53.70 Typical High $134.90 | Facility | None | $12.88 | $53.70 | $134.90 |
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 $38.90 Median $53.70 Typical High $478.63 | Professional | None | $38.90 | $53.70 | $478.63 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $87.10 | Professional | None | $72.44 | $72.44 | $87.10 |
United Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $39.81 | Facility | None | $16.98 | $16.98 | $39.81 |
United Setting Professional Modifier None Typical Low $30.90 Median $45.71 Typical High $72.44 | Professional | None | $30.90 | $45.71 | $72.44 |
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 $23.44 Median $26.92 Typical High $32.36 | Professional | 52 · Reduced service | $23.44 | $26.92 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $10.72 Typical High $12.88 | Professional | 53 · Discontinued | $9.33 | $10.72 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $8.13 Typical High $9.77 | Professional | 55 · Aftercare only | $7.08 | $8.13 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.37 Typical High $6.46 | Professional | 56 · Pre-op care only | $4.68 | $5.37 | $6.46 |
Where Kentucky sits
The same service costs 3.3 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· 22nd 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.