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 $147.91 Median $223.87 Typical High $239.88 | Facility | None | $147.91 | $223.87 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $223.87 Typical High $281.84 | Professional | None | $131.83 | $223.87 | $281.84 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $371.54 | Professional | None | $194.98 | $213.80 | $371.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $269.15 Median $426.58 Typical High $446.68 | Facility | None | $269.15 | $426.58 | $446.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $208.93 Typical High $288.40 | Professional | None | $194.98 | $208.93 | $288.40 |
CareSource Setting Facility Modifier None Typical Low $275.42 Median $380.19 Typical High $616.60 | Facility | None | $275.42 | $380.19 | $616.60 |
CareSource Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $676.08 | Professional | None | $416.87 | $524.81 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $660.69 | Facility | None | $263.03 | $263.03 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $263.03 Typical High $2,344.23 | Professional | None | $194.98 | $263.03 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $323.59 | Professional | None | $269.15 | $269.15 | $323.59 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $275.42 | Facility | None | $213.80 | $213.80 | $275.42 |
United Setting Professional Modifier None Typical Low $141.25 Median $204.17 Typical High $275.42 | Professional | None | $141.25 | $204.17 | $275.42 |
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 $93.33 Median $114.82 Typical High $147.91 | Professional | 52 · Reduced service | $93.33 | $114.82 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $46.77 Typical High $58.88 | Professional | 53 · Discontinued | $37.15 | $46.77 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $34.67 Typical High $44.67 | Professional | 55 · Aftercare only | $28.18 | $34.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $22.91 Typical High $29.51 | Professional | 56 · Pre-op care only | $18.62 | $22.91 | $29.51 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | RR · Rental | $24.55 | $24.55 | $24.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | UE · Used equipment | $186.21 | $186.21 | $186.21 |
Where Kentucky sits
The same service costs 4.7 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· 47th of 51
$214
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.