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 $602.56 Median $954.99 Typical High $1,071.52 | Facility | None | $602.56 | $954.99 | $1,071.52 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $1,000.00 Typical High $1,698.24 | Professional | None | $602.56 | $1,000.00 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,148.15 Median $1,862.09 Typical High $1,949.84 | Facility | None | $1,148.15 | $1,862.09 | $1,949.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,230.27 | Professional | None | $851.14 | $1,000.00 | $1,230.27 |
CareSource Setting Facility Modifier None Typical Low $1,174.90 Median $1,621.81 Typical High $2,630.27 | Facility | None | $1,174.90 | $1,621.81 | $2,630.27 |
CareSource Setting Professional Modifier None Typical Low $1,819.70 Median $2,290.87 Typical High $2,884.03 | Professional | None | $1,819.70 | $2,290.87 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $2,511.89 | Facility | None | $1,318.26 | $1,318.26 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,318.26 Typical High $9,120.11 | Professional | None | $977.24 | $1,318.26 | $9,120.11 |
Molina Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,380.38 | Professional | None | $1,148.15 | $1,148.15 | $1,380.38 |
United Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $831.76 | Facility | None | $645.65 | $645.65 | $831.76 |
United Setting Professional Modifier None Typical Low $616.60 Median $912.01 Typical High $1,258.93 | Professional | None | $616.60 | $912.01 | $1,258.93 |
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 $380.19 Median $501.19 Typical High $851.14 | Professional | 52 · Reduced service | $380.19 | $501.19 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $199.53 Typical High $338.84 | Professional | 53 · Discontinued | $151.36 | $199.53 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $151.36 Typical High $251.19 | Professional | 55 · Aftercare only | $112.20 | $151.36 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $100.00 Typical High $169.82 | Professional | 56 · Pre-op care only | $75.86 | $100.00 | $169.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | RR · Rental | $100.00 | $100.00 | $100.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $758.58 Median $758.58 Typical High $776.25 | Professional | UE · Used equipment | $758.58 | $758.58 | $776.25 |
Where Kentucky sits
The same service costs 2.5 times more in Montana than in Pennsylvania. 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
$1,000
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.