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 $489.78 Median $691.83 Typical High $691.83 | Facility | None | $489.78 | $691.83 | $691.83 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $691.83 Typical High $1,348.96 | Professional | None | $489.78 | $691.83 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $851.14 Median $1,380.38 Typical High $1,445.44 | Facility | None | $851.14 | $1,380.38 | $1,445.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $912.01 | Professional | None | $630.96 | $812.83 | $912.01 |
CareSource Setting Facility Modifier None Typical Low $870.96 Median $1,202.26 Typical High $1,949.84 | Facility | None | $870.96 | $1,202.26 | $1,949.84 |
CareSource Setting Professional Modifier None Typical Low $1,348.96 Median $1,698.24 Typical High $2,137.96 | Professional | None | $1,348.96 | $1,698.24 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $2,187.76 | Facility | None | $870.96 | $870.96 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $870.96 Typical High $7,762.47 | Professional | None | $630.96 | $870.96 | $7,762.47 |
Molina Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,023.29 | Professional | None | $851.14 | $851.14 | $1,023.29 |
United Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $1,513.56 | Facility | None | $891.25 | $891.25 | $1,513.56 |
United Setting Professional Modifier None Typical Low $446.68 Median $676.08 Typical High $1,023.29 | Professional | None | $446.68 | $676.08 | $1,023.29 |
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 $245.47 Median $346.74 Typical High $676.08 | Professional | 52 · Reduced service | $245.47 | $346.74 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $141.25 Typical High $269.15 | Professional | 53 · Discontinued | $97.72 | $141.25 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $104.71 Typical High $204.17 | Professional | 55 · Aftercare only | $74.13 | $104.71 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $69.18 Typical High $134.90 | Professional | 56 · Pre-op care only | $48.98 | $69.18 | $134.90 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | RR · Rental | $81.28 | $81.28 | $81.28 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | UE · Used equipment | $616.60 | $616.60 | $616.60 |
Where Kentucky sits
The same service costs 4.0 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· 40th of 51
$813
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.