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 $288.40 Median $407.38 Typical High $457.09 | Facility | None | $288.40 | $407.38 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $426.58 Typical High $501.19 | Professional | None | $288.40 | $426.58 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $501.19 Median $812.83 Typical High $851.14 | Facility | None | $501.19 | $812.83 | $851.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $478.63 Typical High $537.03 | Professional | None | $371.54 | $478.63 | $537.03 |
CareSource Setting Facility Modifier None Typical Low $512.86 Median $707.95 Typical High $1,148.15 | Facility | None | $512.86 | $707.95 | $1,148.15 |
CareSource Setting Professional Modifier None Typical Low $794.33 Median $977.24 Typical High $1,258.93 | Professional | None | $794.33 | $977.24 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $1,174.90 | Facility | None | $588.84 | $588.84 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $588.84 Typical High $4,168.69 | Professional | None | $426.58 | $588.84 | $4,168.69 |
Molina Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $602.56 | Professional | None | $501.19 | $501.19 | $602.56 |
United Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $398.11 | Facility | None | $181.97 | $181.97 | $398.11 |
United Setting Professional Modifier None Typical Low $269.15 Median $398.11 Typical High $602.56 | Professional | None | $269.15 | $398.11 | $602.56 |
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 $165.96 Median $213.80 Typical High $251.19 | Professional | 52 · Reduced service | $165.96 | $213.80 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $85.11 Typical High $100.00 | Professional | 53 · Discontinued | $67.61 | $85.11 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $64.57 Typical High $75.86 | Professional | 55 · Aftercare only | $50.12 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $42.66 Typical High $50.12 | Professional | 56 · Pre-op care only | $33.88 | $42.66 | $50.12 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | RR · Rental | $47.86 | $47.86 | $47.86 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | UE · Used equipment | $363.08 | $363.08 | $363.08 |
Where Kentucky sits
The same service costs 2.5 times more in Montana than in Alabama. 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· 34th of 51
$479
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.