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 $97.72 Median $107.15 Typical High $112.20 | Facility | None | $97.72 | $107.15 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $112.20 Typical High $131.83 | Professional | None | $97.72 | $112.20 | $131.83 |
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 $120.23 Median $138.04 Typical High $158.49 | Professional | None | $120.23 | $138.04 | $158.49 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.48 Median $11.48 Typical High $12.02 | Professional | RR · Rental | $11.48 | $11.48 | $12.02 |
CareSource Setting Facility Modifier None Typical Low $151.36 Median $204.17 Typical High $295.12 | Facility | None | $151.36 | $204.17 | $295.12 |
CareSource Setting Professional Modifier None Typical Low $204.17 Median $223.87 Typical High $302.00 | Professional | None | $204.17 | $223.87 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $125.89 Typical High $281.84 | Facility | None | $107.15 | $125.89 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $125.89 Typical High $977.24 | Professional | None | $93.33 | $125.89 | $977.24 |
Cigna Setting Professional Modifier RR · Rental Typical Low $10.72 Median $10.72 Typical High $12.59 | Professional | RR · Rental | $10.72 | $10.72 | $12.59 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $190.55 | Professional | None | $158.49 | $158.49 | $190.55 |
United Setting Professional Modifier None Typical Low $67.61 Median $95.50 Typical High $151.36 | Professional | None | $67.61 | $95.50 | $151.36 |
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 $48.98 Median $53.70 Typical High $57.54 | Professional | 52 · Reduced service | $48.98 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $21.88 Typical High $23.44 | Professional | 53 · Discontinued | $19.95 | $21.88 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $16.22 Typical High $17.38 | Professional | 55 · Aftercare only | $14.79 | $16.22 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.96 Typical High $11.75 | Professional | 56 · Pre-op care only | $9.77 | $10.96 | $11.75 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $87.10 Median $87.10 Typical High $89.13 | Professional | UE · Used equipment | $87.10 | $87.10 | $89.13 |
Where Kentucky sits
The same service costs 2.1 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· 24th of 51
$132
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.