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 $562.34 Median $794.33 Typical High $933.25 | Facility | None | $562.34 | $794.33 | $933.25 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $870.96 Typical High $1,380.38 | Professional | None | $660.69 | $870.96 | $1,380.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $977.24 Median $1,584.89 Typical High $1,659.59 | Facility | None | $977.24 | $1,584.89 | $1,659.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $1,445.44 | Professional | None | $724.44 | $933.25 | $1,445.44 |
CareSource Setting Facility Modifier None Typical Low $1,000.00 Median $1,380.38 Typical High $2,238.72 | Facility | None | $1,000.00 | $1,380.38 | $2,238.72 |
CareSource Setting Professional Modifier None Typical Low $1,548.82 Median $1,905.46 Typical High $2,454.71 | Professional | None | $1,548.82 | $1,905.46 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $2,454.71 | Facility | None | $954.99 | $954.99 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $8,709.64 | Professional | None | $707.95 | $954.99 | $8,709.64 |
Molina Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,174.90 | Professional | None | $977.24 | $977.24 | $1,174.90 |
United Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $1,023.29 | Facility | None | $173.78 | $173.78 | $1,023.29 |
United Setting Professional Modifier None Typical Low $524.81 Median $776.25 Typical High $1,174.90 | Professional | None | $524.81 | $776.25 | $1,174.90 |
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 $331.13 Median $436.52 Typical High $776.25 | Professional | 52 · Reduced service | $331.13 | $436.52 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $173.78 Typical High $309.03 | Professional | 53 · Discontinued | $131.83 | $173.78 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $131.83 Typical High $229.09 | Professional | 55 · Aftercare only | $97.72 | $131.83 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $87.10 Typical High $154.88 | Professional | 56 · Pre-op care only | $66.07 | $87.10 | $154.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $144.54 Median $144.54 Typical High $169.82 | Professional | RR · Rental | $144.54 | $144.54 | $169.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $933.25 Median $1,096.48 Typical High $1,288.25 | Professional | UE · Used equipment | $933.25 | $1,096.48 | $1,288.25 |
Where Kentucky sits
The same service costs 3.2 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
$933
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.