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 $114.82 Typical High $123.03 | Facility | None | $81.28 | $114.82 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $123.03 Typical High $223.87 | Professional | None | $81.28 | $123.03 | $223.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $141.25 Median $229.09 Typical High $239.88 | Facility | None | $141.25 | $229.09 | $239.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $134.90 Typical High $151.36 | Professional | None | $104.71 | $134.90 | $151.36 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $100.00 Median $100.00 Typical High $134.90 | Professional | UE · Used equipment | $100.00 | $100.00 | $134.90 |
CareSource Setting Facility Modifier None Typical Low $144.54 Median $199.53 Typical High $323.59 | Facility | None | $144.54 | $199.53 | $323.59 |
CareSource Setting Professional Modifier None Typical Low $223.87 Median $275.42 Typical High $354.81 | Professional | None | $223.87 | $275.42 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $346.74 | Facility | None | $138.04 | $138.04 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $1,230.27 | Professional | None | $102.33 | $138.04 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $169.82 | Professional | None | $141.25 | $141.25 | $169.82 |
United Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $154.88 | Facility | None | $147.91 | $147.91 | $154.88 |
United Setting Professional Modifier None Typical Low $75.86 Median $109.65 Typical High $169.82 | Professional | None | $75.86 | $109.65 | $169.82 |
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 $46.77 Median $61.66 Typical High $112.20 | Professional | 52 · Reduced service | $46.77 | $61.66 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $24.55 Typical High $44.67 | Professional | 53 · Discontinued | $19.05 | $24.55 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $18.62 Typical High $33.11 | Professional | 55 · Aftercare only | $12.02 | $18.62 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $12.30 Typical High $22.39 | Professional | 56 · Pre-op care only | $8.13 | $12.30 | $22.39 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | RR · Rental | $13.49 | $13.49 | $13.49 |
Where Kentucky sits
The same service costs 3.5 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· 38th of 51
$135
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.