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 $831.76 Median $1,479.11 Typical High $1,548.82 | Facility | None | $831.76 | $1,479.11 | $1,548.82 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $1,479.11 Typical High $2,344.23 | Professional | None | $831.76 | $1,479.11 | $2,344.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $2,951.21 Typical High $3,090.30 | Facility | None | $1,819.70 | $2,951.21 | $3,090.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,445.44 Typical High $1,949.84 | Professional | None | $1,348.96 | $1,445.44 | $1,949.84 |
CareSource Setting Facility Modifier None Typical Low $1,862.09 Median $2,570.40 Typical High $4,168.69 | Facility | None | $1,862.09 | $2,570.40 | $4,168.69 |
CareSource Setting Professional Modifier None Typical Low $2,884.03 Median $3,548.13 Typical High $4,570.88 | Professional | None | $2,884.03 | $3,548.13 | $4,570.88 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $3,981.07 | Facility | None | $1,819.70 | $1,819.70 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,819.70 Typical High $12,589.25 | Professional | None | $1,318.26 | $1,819.70 | $12,589.25 |
Molina Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,187.76 | Professional | None | $1,819.70 | $1,819.70 | $2,187.76 |
United Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $1,148.15 | Facility | None | $870.96 | $870.96 | $1,148.15 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,412.54 Typical High $1,905.46 | Professional | None | $954.99 | $1,412.54 | $1,905.46 |
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 $501.19 Median $741.31 Typical High $1,174.90 | Professional | 52 · Reduced service | $501.19 | $741.31 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $295.12 Typical High $467.74 | Professional | 53 · Discontinued | $199.53 | $295.12 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $223.87 Typical High $346.74 | Professional | 55 · Aftercare only | $151.36 | $223.87 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $147.91 Typical High $234.42 | Professional | 56 · Pre-op care only | $100.00 | $147.91 | $234.42 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | RR · Rental | $169.82 | $169.82 | $169.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | UE · Used equipment | $1,288.25 | $1,288.25 | $1,288.25 |
Where Kentucky sits
The same service costs 2.3 times more in Wisconsin 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· 39th of 51
$1,445
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.