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 $2,137.96 Median $2,454.71 Typical High $2,630.27 | Facility | None | $2,137.96 | $2,454.71 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $2,511.89 Typical High $3,981.07 | Professional | None | $2,137.96 | $2,511.89 | $3,981.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,019.95 Median $4,786.30 Typical High $5,011.87 | Facility | None | $3,019.95 | $4,786.30 | $5,011.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,754.23 Median $3,019.95 Typical High $3,630.78 | Professional | None | $2,754.23 | $3,019.95 | $3,630.78 |
CareSource Setting Facility Modifier None Typical Low $3,090.30 Median $4,265.80 Typical High $6,918.31 | Facility | None | $3,090.30 | $4,265.80 | $6,918.31 |
CareSource Setting Professional Modifier None Typical Low $4,677.35 Median $5,888.44 Typical High $7,585.78 | Professional | None | $4,677.35 | $5,888.44 | $7,585.78 |
Cigna Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $6,606.93 | Facility | None | $3,019.95 | $3,019.95 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $3,019.95 Typical High $22,387.21 | Professional | None | $2,187.76 | $3,019.95 | $22,387.21 |
Molina Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
United Setting Professional Modifier None Typical Low $1,621.81 Median $2,344.23 Typical High $3,235.94 | Professional | None | $1,621.81 | $2,344.23 | $3,235.94 |
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 $1,071.52 Median $1,230.27 Typical High $1,995.26 | Professional | 52 · Reduced service | $1,071.52 | $1,230.27 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $501.19 Typical High $794.33 | Professional | 53 · Discontinued | $426.58 | $501.19 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $371.54 Typical High $588.84 | Professional | 55 · Aftercare only | $316.23 | $371.54 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $251.19 Typical High $398.11 | Professional | 56 · Pre-op care only | $213.80 | $251.19 | $398.11 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | RR · Rental | $302.00 | $302.00 | $302.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | UE · Used equipment | $2,290.87 | $2,290.87 | $2,290.87 |
Where Kentucky sits
The same service costs 2.4 times more in Hawaii than in West Virginia. 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· 19th of 51
$3,020
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.