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 $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $81.28 Typical High $151.36 | Professional | None | $75.86 | $81.28 | $151.36 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $134.90 Typical High $134.90 | Professional | None | $117.49 | $134.90 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $97.72 Median $158.49 Typical High $165.96 | Facility | None | $97.72 | $158.49 | $165.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $83.18 Typical High $104.71 | Professional | None | $72.44 | $83.18 | $104.71 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | RR · Rental | $9.33 | $9.33 | $9.33 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | UE · Used equipment | $69.18 | $69.18 | $69.18 |
CareSource Setting Facility Modifier None Typical Low $100.00 Median $141.25 Typical High $223.87 | Facility | None | $100.00 | $141.25 | $223.87 |
CareSource Setting Professional Modifier None Typical Low $154.88 Median $194.98 Typical High $251.19 | Professional | None | $154.88 | $194.98 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $213.80 | Facility | None | $100.00 | $100.00 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $100.00 Typical High $758.58 | Professional | None | $72.44 | $100.00 | $758.58 |
Molina Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $112.20 | Professional | None | $93.33 | $93.33 | $112.20 |
United Setting Professional Modifier None Typical Low $51.29 Median $77.62 Typical High $107.15 | Professional | None | $51.29 | $77.62 | $107.15 |
2 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 55 · Aftercare only Typical Low $11.22 Median $12.02 Typical High $22.39 | Professional | 55 · Aftercare only | $11.22 | $12.02 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.94 Typical High $15.14 | Professional | 56 · Pre-op care only | $7.59 | $7.94 | $15.14 |
Where Kentucky sits
The same service costs 2.2 times more in Montana than in Florida. 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· 44th of 51
$83.18
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.