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 $158.49 Median $234.42 Typical High $251.19 | Facility | None | $158.49 | $234.42 | $251.19 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $245.47 Typical High $446.68 | Professional | None | $158.49 | $245.47 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $288.40 Median $457.09 Typical High $478.63 | Facility | None | $288.40 | $457.09 | $478.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $263.03 Typical High $302.00 | Professional | None | $208.93 | $263.03 | $302.00 |
CareSource Setting Facility Modifier None Typical Low $295.12 Median $407.38 Typical High $660.69 | Facility | None | $295.12 | $407.38 | $660.69 |
CareSource Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $724.44 | Professional | None | $446.68 | $562.34 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $676.08 | Facility | None | $316.23 | $316.23 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $316.23 Typical High $2,398.83 | Professional | None | $229.09 | $316.23 | $2,398.83 |
Molina Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $346.74 | Professional | None | $288.40 | $288.40 | $346.74 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $257.04 | Facility | None | $213.80 | $213.80 | $257.04 |
United Setting Professional Modifier None Typical Low $154.88 Median $223.87 Typical High $338.84 | Professional | None | $154.88 | $223.87 | $338.84 |
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 $95.50 Median $123.03 Typical High $223.87 | Professional | 52 · Reduced service | $95.50 | $123.03 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $48.98 Typical High $91.20 | Professional | 53 · Discontinued | $38.02 | $48.98 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $36.31 Typical High $67.61 | Professional | 55 · Aftercare only | $28.84 | $36.31 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $24.55 Typical High $44.67 | Professional | 56 · Pre-op care only | $19.05 | $24.55 | $44.67 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | RR · Rental | $26.92 | $26.92 | $26.92 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | UE · Used equipment | $204.17 | $204.17 | $204.17 |
Where Kentucky sits
The same service costs 2.5 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· 42nd of 51
$263
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.