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 $173.78 Median $251.19 Typical High $295.12 | Facility | None | $173.78 | $251.19 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $478.63 | Professional | None | $204.17 | $275.42 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $309.03 Median $489.78 Typical High $512.86 | Facility | None | $309.03 | $489.78 | $512.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $288.40 Typical High $323.59 | Professional | None | $223.87 | $288.40 | $323.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | UE · Used equipment | $218.78 | $218.78 | $218.78 |
CareSource Setting Facility Modifier None Typical Low $316.23 Median $436.52 Typical High $691.83 | Facility | None | $316.23 | $436.52 | $691.83 |
CareSource Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $776.25 | Professional | None | $478.63 | $602.56 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $776.25 | Facility | None | $363.08 | $363.08 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $363.08 Typical High $2,754.23 | Professional | None | $269.15 | $363.08 | $2,754.23 |
Molina Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $371.54 | Professional | None | $309.03 | $309.03 | $371.54 |
United Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $323.59 | Facility | None | $239.88 | $239.88 | $323.59 |
United Setting Professional Modifier None Typical Low $165.96 Median $239.88 Typical High $371.54 | Professional | None | $165.96 | $239.88 | $371.54 |
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 $102.33 Median $138.04 Typical High $239.88 | Professional | 52 · Reduced service | $102.33 | $138.04 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $54.95 Typical High $95.50 | Professional | 53 · Discontinued | $40.74 | $54.95 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $41.69 Typical High $72.44 | Professional | 55 · Aftercare only | $30.90 | $41.69 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $27.54 Typical High $47.86 | Professional | 56 · Pre-op care only | $20.42 | $27.54 | $47.86 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | RR · Rental | $29.51 | $29.51 | $29.51 |
Where Kentucky sits
The same service costs 2.6 times more in Hawaii than in Alabama. 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· 41st of 51
$288
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.