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 $66.07 Median $107.15 Typical High $112.20 | Facility | None | $66.07 | $107.15 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $109.65 Typical High $125.89 | Professional | None | $89.13 | $109.65 | $125.89 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $128.82 Median $208.93 Typical High $218.78 | Facility | None | $128.82 | $208.93 | $218.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $97.72 Typical High $138.04 | Professional | None | $95.50 | $97.72 | $138.04 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $74.13 Median $81.28 Typical High $81.28 | Professional | UE · Used equipment | $74.13 | $81.28 | $81.28 |
CareSource Setting Facility Modifier None Typical Low $131.83 Median $181.97 Typical High $295.12 | Facility | None | $131.83 | $181.97 | $295.12 |
CareSource Setting Professional Modifier None Typical Low $204.17 Median $257.04 Typical High $323.59 | Professional | None | $204.17 | $257.04 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $281.84 | Facility | None | $112.20 | $112.20 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $112.20 Typical High $977.24 | Professional | None | $83.18 | $112.20 | $977.24 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $154.88 | Professional | None | $128.82 | $128.82 | $154.88 |
United Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
United Setting Professional Modifier None Typical Low $67.61 Median $91.20 Typical High $134.90 | Professional | None | $67.61 | $91.20 | $134.90 |
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 $44.67 Median $53.70 Typical High $57.54 | Professional | 52 · Reduced service | $44.67 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $21.88 Typical High $23.44 | Professional | 53 · Discontinued | $17.78 | $21.88 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $16.22 Typical High $17.38 | Professional | 55 · Aftercare only | $13.49 | $16.22 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $10.96 Typical High $11.75 | Professional | 56 · Pre-op care only | $8.91 | $10.96 | $11.75 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | RR · Rental | $10.96 | $10.96 | $10.96 |
Where Kentucky sits
The same service costs 2.3 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· 49th of 51
$102
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.