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 $37.15 Median $56.23 Typical High $57.54 | Facility | None | $37.15 | $56.23 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $56.23 Typical High $72.44 | Professional | None | $46.77 | $56.23 | $72.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $67.61 Median $109.65 Typical High $114.82 | Facility | None | $67.61 | $109.65 | $114.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $60.26 Typical High $72.44 | Professional | None | $50.12 | $60.26 | $72.44 |
CareSource Setting Facility Modifier None Typical Low $69.18 Median $95.50 Typical High $154.88 | Facility | None | $69.18 | $95.50 | $154.88 |
CareSource Setting Professional Modifier None Typical Low $107.15 Median $131.83 Typical High $169.82 | Professional | None | $107.15 | $131.83 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $158.49 | Facility | None | $66.07 | $66.07 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $66.07 Typical High $562.34 | Professional | None | $48.98 | $66.07 | $562.34 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $81.28 | Professional | None | $67.61 | $67.61 | $81.28 |
United Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $61.66 | Facility | None | $46.77 | $46.77 | $61.66 |
United Setting Professional Modifier None Typical Low $35.48 Median $50.12 Typical High $77.62 | Professional | None | $35.48 | $50.12 | $77.62 |
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 $23.44 Median $28.18 Typical High $36.31 | Professional | 52 · Reduced service | $23.44 | $28.18 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $11.22 Typical High $14.45 | Professional | 53 · Discontinued | $9.33 | $11.22 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $8.51 Typical High $10.72 | Professional | 55 · Aftercare only | $7.08 | $8.51 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.62 Typical High $7.24 | Professional | 56 · Pre-op care only | $4.68 | $5.62 | $7.24 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | RR · Rental | $6.17 | $6.17 | $6.17 |
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 |
Where Kentucky sits
The same service costs 2.7 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· 39th of 51
$60.26
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.