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 $147.91 Median $213.80 Typical High $239.88 | Facility | None | $147.91 | $213.80 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $223.87 Typical High $407.38 | Professional | None | $147.91 | $223.87 | $407.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $257.04 Median $416.87 Typical High $436.52 | Facility | None | $257.04 | $416.87 | $436.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $245.47 Typical High $275.42 | Professional | None | $190.55 | $245.47 | $275.42 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | UE · Used equipment | $181.97 | $181.97 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $263.03 Median $371.54 Typical High $588.84 | Facility | None | $263.03 | $371.54 | $588.84 |
CareSource Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $660.69 | Professional | None | $407.38 | $512.86 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $630.96 | Facility | None | $302.00 | $302.00 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $302.00 Typical High $2,238.72 | Professional | None | $218.78 | $302.00 | $2,238.72 |
Molina Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $281.84 | Professional | None | $234.42 | $234.42 | $281.84 |
United Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
United Setting Professional Modifier None Typical Low $138.04 Median $204.17 Typical High $316.23 | Professional | None | $138.04 | $204.17 | $316.23 |
5 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 $87.10 Median $112.20 Typical High $204.17 | Professional | 52 · Reduced service | $87.10 | $112.20 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $45.71 Typical High $81.28 | Professional | 53 · Discontinued | $34.67 | $45.71 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $33.88 Typical High $61.66 | Professional | 55 · Aftercare only | $26.30 | $33.88 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $22.39 Typical High $40.74 | Professional | 56 · Pre-op care only | $17.38 | $22.39 | $40.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | RR · Rental | $24.55 | $24.55 | $24.55 |
Where Kentucky sits
The same service costs 2.5 times more in Hawaii 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· 39th of 51
$245
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.