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 $630.96 Median $891.25 Typical High $1,000.00 | Facility | None | $630.96 | $891.25 | $1,000.00 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,737.80 | Professional | None | $741.31 | $933.25 | $1,737.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $1,778.28 Typical High $1,862.09 | Facility | None | $1,096.48 | $1,778.28 | $1,862.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,174.90 | Professional | None | $812.83 | $1,047.13 | $1,174.90 |
CareSource Setting Facility Modifier None Typical Low $1,122.02 Median $1,548.82 Typical High $2,511.89 | Facility | None | $1,122.02 | $1,548.82 | $2,511.89 |
CareSource Setting Professional Modifier None Typical Low $1,737.80 Median $2,137.96 Typical High $2,754.23 | Professional | None | $1,737.80 | $2,137.96 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $2,754.23 | Facility | None | $1,230.27 | $1,230.27 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,230.27 Typical High $9,772.37 | Professional | None | $891.25 | $1,230.27 | $9,772.37 |
Molina Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,318.26 | Professional | None | $1,096.48 | $1,096.48 | $1,318.26 |
United Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $1,148.15 | Facility | None | $977.24 | $977.24 | $1,148.15 |
United Setting Professional Modifier None Typical Low $588.84 Median $870.96 Typical High $1,318.26 | Professional | None | $588.84 | $870.96 | $1,318.26 |
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 $363.08 Median $467.74 Typical High $870.96 | Professional | 52 · Reduced service | $363.08 | $467.74 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $186.21 Typical High $346.74 | Professional | 53 · Discontinued | $147.91 | $186.21 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $138.04 Typical High $257.04 | Professional | 55 · Aftercare only | $109.65 | $138.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $93.33 Typical High $173.78 | Professional | 56 · Pre-op care only | $74.13 | $93.33 | $173.78 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | RR · Rental | $104.71 | $104.71 | $104.71 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | UE · Used equipment | $794.33 | $794.33 | $794.33 |
Where Kentucky sits
The same service costs 2.8 times more in Hawaii than in Pennsylvania. 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· 41st of 51
$1,047
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.