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 $123.03 Median $186.21 Typical High $208.93 | Facility | None | $123.03 | $186.21 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $194.98 Typical High $338.84 | Professional | None | $123.03 | $194.98 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $229.09 Median $363.08 Typical High $389.05 | Facility | None | $229.09 | $363.08 | $389.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $204.17 Typical High $245.47 | Professional | None | $169.82 | $204.17 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $234.42 Median $323.59 Typical High $524.81 | Facility | None | $234.42 | $323.59 | $524.81 |
CareSource Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $575.44 | Professional | None | $363.08 | $446.68 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $512.86 | Facility | None | $269.15 | $269.15 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $269.15 Typical High $1,819.70 | Professional | None | $199.53 | $269.15 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $275.42 | Professional | None | $229.09 | $229.09 | $275.42 |
United Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $173.78 | Facility | None | $158.49 | $158.49 | $173.78 |
United Setting Professional Modifier None Typical Low $123.03 Median $177.83 Typical High $257.04 | Professional | None | $123.03 | $177.83 | $257.04 |
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 $75.86 Median $97.72 Typical High $169.82 | Professional | 52 · Reduced service | $75.86 | $97.72 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $39.81 Typical High $67.61 | Professional | 53 · Discontinued | $30.20 | $39.81 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $29.51 Typical High $51.29 | Professional | 55 · Aftercare only | $22.91 | $29.51 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $19.50 Typical High $33.88 | Professional | 56 · Pre-op care only | $15.14 | $19.50 | $33.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | RR · Rental | $21.38 | $21.38 | $21.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | UE · Used equipment | $162.18 | $162.18 | $162.18 |
Where Kentucky sits
The same service costs 2.0 times more in Wisconsin than in Colorado. 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· 42nd of 51
$204
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.