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 $251.19 Median $363.08 Typical High $363.08 | Facility | None | $251.19 | $363.08 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $691.83 | Professional | None | $251.19 | $363.08 | $691.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $436.52 Median $707.95 Typical High $741.31 | Facility | None | $436.52 | $707.95 | $741.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $457.09 | Professional | None | $323.59 | $416.87 | $457.09 |
CareSource Setting Facility Modifier None Typical Low $446.68 Median $616.60 Typical High $1,000.00 | Facility | None | $446.68 | $616.60 | $1,000.00 |
CareSource Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,096.48 | Professional | None | $691.83 | $870.96 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $1,023.29 | Facility | None | $436.52 | $436.52 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $436.52 Typical High $3,630.78 | Professional | None | $316.23 | $436.52 | $3,630.78 |
Molina Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $524.81 | Professional | None | $436.52 | $436.52 | $524.81 |
United Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $346.74 | Facility | None | $257.04 | $257.04 | $346.74 |
United Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $537.03 | Professional | None | $229.09 | $346.74 | $537.03 |
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 $125.89 Median $181.97 Typical High $346.74 | Professional | 52 · Reduced service | $125.89 | $181.97 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $72.44 Typical High $138.04 | Professional | 53 · Discontinued | $50.12 | $72.44 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $53.70 Typical High $104.71 | Professional | 55 · Aftercare only | $38.02 | $53.70 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $36.31 Typical High $69.18 | Professional | 56 · Pre-op care only | $25.12 | $36.31 | $69.18 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | RR · Rental | $41.69 | $41.69 | $41.69 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | UE · Used equipment | $316.23 | $316.23 | $316.23 |
Where Kentucky sits
The same service costs 2.8 times more in Montana than in Florida. 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· 36th of 51
$417
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.