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 $537.03 Median $831.76 Typical High $831.76 | Facility | None | $537.03 | $831.76 | $831.76 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $831.76 Typical High $1,548.82 | Professional | None | $537.03 | $831.76 | $1,548.82 |
Ambetter Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,023.29 Median $1,621.81 Typical High $1,698.24 | Facility | None | $1,023.29 | $1,621.81 | $1,698.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $851.14 Typical High $1,047.13 | Professional | None | $741.31 | $851.14 | $1,047.13 |
CareSource Setting Facility Modifier None Typical Low $1,047.13 Median $1,445.44 Typical High $2,290.87 | Facility | None | $1,047.13 | $1,445.44 | $2,290.87 |
CareSource Setting Professional Modifier None Typical Low $1,584.89 Median $1,995.26 Typical High $2,570.40 | Professional | None | $1,584.89 | $1,995.26 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $2,238.72 | Facility | None | $891.25 | $891.25 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $891.25 Typical High $7,762.47 | Professional | None | $645.65 | $891.25 | $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 Professional Modifier None Typical Low $537.03 Median $794.33 Typical High $1,096.48 | Professional | None | $537.03 | $794.33 | $1,096.48 |
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 $338.84 Median $416.87 Typical High $776.25 | Professional | 52 · Reduced service | $338.84 | $416.87 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $165.96 Typical High $309.03 | Professional | 53 · Discontinued | $134.90 | $165.96 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $123.03 Typical High $234.42 | Professional | 55 · Aftercare only | $102.33 | $123.03 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $83.18 Typical High $154.88 | Professional | 56 · Pre-op care only | $67.61 | $83.18 | $154.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | RR · Rental | $95.50 | $95.50 | $95.50 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | UE · Used equipment | $707.95 | $707.95 | $707.95 |
Where Kentucky sits
The same service costs 2.6 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
$851
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.