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 $131.83 Median $190.55 Typical High $208.93 | Facility | None | $131.83 | $190.55 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $190.55 Typical High $363.08 | Professional | None | $131.83 | $190.55 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $251.19 Median $407.38 Typical High $426.58 | Facility | None | $251.19 | $407.38 | $426.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $177.83 Median $218.78 Typical High $263.03 | Professional | None | $177.83 | $218.78 | $263.03 |
CareSource Setting Facility Modifier None Typical Low $257.04 Median $354.81 Typical High $575.44 | Facility | None | $257.04 | $354.81 | $575.44 |
CareSource Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $630.96 | Professional | None | $398.11 | $501.19 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $562.34 | Facility | None | $229.09 | $229.09 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $229.09 Typical High $1,995.26 | Professional | None | $165.96 | $229.09 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $302.00 | Professional | None | $251.19 | $251.19 | $302.00 |
United Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $190.55 | Facility | None | $151.36 | $151.36 | $190.55 |
United Setting Professional Modifier None Typical Low $131.83 Median $199.53 Typical High $281.84 | Professional | None | $131.83 | $199.53 | $281.84 |
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 $85.11 Median $95.50 Typical High $181.97 | Professional | 52 · Reduced service | $85.11 | $95.50 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $38.02 Typical High $72.44 | Professional | 53 · Discontinued | $33.88 | $38.02 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $28.18 Typical High $53.70 | Professional | 55 · Aftercare only | $25.12 | $28.18 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $19.05 Typical High $36.31 | Professional | 56 · Pre-op care only | $16.98 | $19.05 | $36.31 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | RR · Rental | $21.88 | $21.88 | $21.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | UE · Used equipment | $165.96 | $165.96 | $165.96 |
Where Kentucky sits
The same service costs 2.7 times more in Montana 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· 43rd of 51
$219
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.