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 $75.86 Median $120.23 Typical High $134.90 | Facility | None | $75.86 | $120.23 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $125.89 Typical High $213.80 | Professional | None | $75.86 | $125.89 | $213.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $144.54 Median $234.42 Typical High $245.47 | Facility | None | $144.54 | $234.42 | $245.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $128.82 Typical High $151.36 | Professional | None | $107.15 | $128.82 | $151.36 |
CareSource Setting Facility Modifier None Typical Low $147.91 Median $208.93 Typical High $331.13 | Facility | None | $147.91 | $208.93 | $331.13 |
CareSource Setting Professional Modifier None Typical Low $229.09 Median $288.40 Typical High $371.54 | Professional | None | $229.09 | $288.40 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $316.23 | Facility | None | $173.78 | $173.78 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $173.78 Typical High $1,148.15 | Professional | None | $128.82 | $173.78 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $177.83 | Professional | None | $147.91 | $147.91 | $177.83 |
United Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $109.65 | Facility | None | $85.11 | $85.11 | $109.65 |
United Setting Professional Modifier None Typical Low $77.62 Median $114.82 Typical High $158.49 | Professional | None | $77.62 | $114.82 | $158.49 |
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 $45.71 Median $63.10 Typical High $107.15 | Professional | 52 · Reduced service | $45.71 | $63.10 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $25.12 Typical High $42.66 | Professional | 53 · Discontinued | $18.20 | $25.12 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $19.05 Typical High $32.36 | Professional | 55 · Aftercare only | $13.80 | $19.05 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $12.59 Typical High $21.38 | Professional | 56 · Pre-op care only | $9.12 | $12.59 | $21.38 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | RR · Rental | $13.80 | $13.80 | $13.80 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $97.72 Median $102.33 Typical High $102.33 | Professional | UE · Used equipment | $97.72 | $102.33 | $102.33 |
Where Kentucky sits
The same service costs 2.0 times more in Wisconsin 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· 45th of 51
$129
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.