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 $204.17 Median $323.59 Typical High $346.74 | Facility | None | $204.17 | $323.59 | $346.74 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $323.59 Typical High $446.68 | Professional | None | $245.47 | $323.59 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $416.87 Median $676.08 Typical High $707.95 | Facility | None | $416.87 | $676.08 | $707.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $323.59 Typical High $446.68 | Professional | None | $281.84 | $323.59 | $446.68 |
CareSource Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $954.99 | Facility | None | $426.58 | $588.84 | $954.99 |
CareSource Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,047.13 | Professional | None | $660.69 | $812.83 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $912.01 | Facility | None | $371.54 | $371.54 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $371.54 Typical High $3,090.30 | Professional | None | $275.42 | $371.54 | $3,090.30 |
Molina Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $501.19 | Professional | None | $416.87 | $416.87 | $501.19 |
United Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $371.54 | Facility | None | $269.15 | $269.15 | $371.54 |
United Setting Professional Modifier None Typical Low $213.80 Median $295.12 Typical High $436.52 | Professional | None | $213.80 | $295.12 | $436.52 |
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 $123.03 Median $162.18 Typical High $223.87 | Professional | 52 · Reduced service | $123.03 | $162.18 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $64.57 Typical High $89.13 | Professional | 53 · Discontinued | $48.98 | $64.57 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $48.98 Typical High $67.61 | Professional | 55 · Aftercare only | $36.31 | $48.98 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $32.36 Typical High $44.67 | Professional | 56 · Pre-op care only | $24.55 | $32.36 | $44.67 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | RR · Rental | $33.88 | $33.88 | $33.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | UE · Used equipment | $257.04 | $257.04 | $257.04 |
Where Kentucky sits
The same service costs 3.0 times more in Hawaii than in Vermont. 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· 38th of 51
$324
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.