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 $70.79 Median $102.33 Typical High $104.71 | Facility | None | $70.79 | $102.33 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $102.33 Typical High $199.53 | Professional | None | $70.79 | $102.33 | $199.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $128.82 Median $204.17 Typical High $213.80 | Facility | None | $128.82 | $204.17 | $213.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $117.49 Typical High $131.83 | Professional | None | $93.33 | $117.49 | $131.83 |
CareSource Setting Facility Modifier None Typical Low $131.83 Median $181.97 Typical High $288.40 | Facility | None | $131.83 | $181.97 | $288.40 |
CareSource Setting Professional Modifier None Typical Low $199.53 Median $251.19 Typical High $323.59 | Professional | None | $199.53 | $251.19 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $302.00 | Facility | None | $123.03 | $123.03 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $1,096.48 | Professional | None | $89.13 | $123.03 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $154.88 | Professional | None | $128.82 | $128.82 | $154.88 |
United Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $131.83 | Facility | None | $107.15 | $107.15 | $131.83 |
United Setting Professional Modifier None Typical Low $67.61 Median $100.00 Typical High $151.36 | Professional | None | $67.61 | $100.00 | $151.36 |
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 $42.66 Median $51.29 Typical High $100.00 | Professional | 52 · Reduced service | $42.66 | $51.29 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $20.42 Typical High $39.81 | Professional | 53 · Discontinued | $16.98 | $20.42 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $15.14 Typical High $30.20 | Professional | 55 · Aftercare only | $12.88 | $15.14 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $10.23 Typical High $19.95 | Professional | 56 · Pre-op care only | $8.51 | $10.23 | $19.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | RR · Rental | $12.02 | $12.02 | $12.02 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | UE · Used equipment | $89.13 | $89.13 | $89.13 |
Where Kentucky sits
The same service costs 3.0 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· 43rd of 51
$117
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.