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 $190.55 Median $275.42 Typical High $323.59 | Facility | None | $190.55 | $275.42 | $323.59 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $302.00 Typical High $524.81 | Professional | None | $223.87 | $302.00 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $338.84 Median $537.03 Typical High $562.34 | Facility | None | $338.84 | $537.03 | $562.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $354.81 | Professional | None | $245.47 | $316.23 | $354.81 |
CareSource Setting Facility Modifier None Typical Low $346.74 Median $478.63 Typical High $758.58 | Facility | None | $346.74 | $478.63 | $758.58 |
CareSource Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $851.14 | Professional | None | $524.81 | $660.69 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $812.83 | Facility | None | $398.11 | $398.11 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $398.11 Typical High $2,884.03 | Professional | None | $295.12 | $398.11 | $2,884.03 |
Molina Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $407.38 | Professional | None | $338.84 | $338.84 | $407.38 |
United Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $331.13 | Facility | None | $257.04 | $257.04 | $331.13 |
United Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $407.38 | Professional | None | $177.83 | $263.03 | $407.38 |
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 $112.20 Median $151.36 Typical High $263.03 | Professional | 52 · Reduced service | $112.20 | $151.36 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $60.26 Typical High $104.71 | Professional | 53 · Discontinued | $44.67 | $60.26 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $45.71 Typical High $79.43 | Professional | 55 · Aftercare only | $33.88 | $45.71 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $30.20 Typical High $52.48 | Professional | 56 · Pre-op care only | $22.39 | $30.20 | $52.48 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | RR · Rental | $32.36 | $32.36 | $32.36 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | UE · Used equipment | $239.88 | $239.88 | $239.88 |
Where Kentucky sits
The same service costs 2.5 times more in Hawaii than in Washington, DC. 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· 40th of 51
$316
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.