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 $117.49 Median $169.82 Typical High $169.82 | Facility | None | $117.49 | $169.82 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $169.82 Typical High $323.59 | Professional | None | $117.49 | $169.82 | $323.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $208.93 Median $331.13 Typical High $346.74 | Facility | None | $208.93 | $331.13 | $346.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $151.36 Median $194.98 Typical High $218.78 | Professional | None | $151.36 | $194.98 | $218.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | UE · Used equipment | $147.91 | $147.91 | $147.91 |
CareSource Setting Facility Modifier None Typical Low $213.80 Median $295.12 Typical High $467.74 | Facility | None | $213.80 | $295.12 | $467.74 |
CareSource Setting Professional Modifier None Typical Low $323.59 Median $407.38 Typical High $524.81 | Professional | None | $323.59 | $407.38 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $501.19 | Facility | None | $204.17 | $204.17 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $1,819.70 | Professional | None | $147.91 | $204.17 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $251.19 | Professional | None | $208.93 | $208.93 | $251.19 |
United Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $218.78 | Facility | None | $181.97 | $181.97 | $218.78 |
United Setting Professional Modifier None Typical Low $107.15 Median $162.18 Typical High $251.19 | Professional | None | $107.15 | $162.18 | $251.19 |
5 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 $58.88 Median $85.11 Typical High $162.18 | Professional | 52 · Reduced service | $58.88 | $85.11 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $33.88 Typical High $64.57 | Professional | 53 · Discontinued | $23.44 | $33.88 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $25.12 Typical High $48.98 | Professional | 55 · Aftercare only | $17.78 | $25.12 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $16.98 Typical High $32.36 | Professional | 56 · Pre-op care only | $11.75 | $16.98 | $32.36 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | RR · Rental | $19.50 | $19.50 | $19.50 |
Where Kentucky sits
The same service costs 3.3 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· 41st of 51
$195
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.