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 $229.09 Median $331.13 Typical High $389.05 | Facility | None | $229.09 | $331.13 | $389.05 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $371.54 Typical High $645.65 | Professional | None | $229.09 | $371.54 | $645.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $407.38 Median $660.69 Typical High $691.83 | Facility | None | $407.38 | $660.69 | $691.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $426.58 | Professional | None | $302.00 | $380.19 | $426.58 |
CareSource Setting Facility Modifier None Typical Low $416.87 Median $575.44 Typical High $933.25 | Facility | None | $416.87 | $575.44 | $933.25 |
CareSource Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,023.29 | Professional | None | $645.65 | $812.83 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $977.24 | Facility | None | $398.11 | $398.11 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $3,467.37 | Professional | None | $288.40 | $398.11 | $3,467.37 |
Molina Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $489.78 | Professional | None | $407.38 | $407.38 | $489.78 |
United Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
United Setting Professional Modifier None Typical Low $218.78 Median $323.59 Typical High $489.78 | Professional | None | $218.78 | $323.59 | $489.78 |
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 $138.04 Median $186.21 Typical High $323.59 | Professional | 52 · Reduced service | $138.04 | $186.21 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $74.13 Typical High $128.82 | Professional | 53 · Discontinued | $54.95 | $74.13 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $54.95 Typical High $95.50 | Professional | 55 · Aftercare only | $40.74 | $54.95 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $37.15 Typical High $64.57 | Professional | 56 · Pre-op care only | $27.54 | $37.15 | $64.57 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | RR · Rental | $38.02 | $38.02 | $38.02 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $281.84 Median $288.40 Typical High $288.40 | Professional | UE · Used equipment | $281.84 | $288.40 | $288.40 |
Where Kentucky sits
The same service costs 2.8 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· 36th of 51
$380
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.