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 $4,466.84 Median $6,760.83 Typical High $7,244.36 | Facility | None | $4,466.84 | $6,760.83 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $5,495.41 Median $6,918.31 Typical High $12,302.69 | Professional | None | $5,495.41 | $6,918.31 | $12,302.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,128.31 Median $13,182.57 Typical High $13,803.84 | Facility | None | $8,128.31 | $13,182.57 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $6,025.60 Median $7,413.10 Typical High $8,709.64 | Professional | None | $6,025.60 | $7,413.10 | $8,709.64 |
CareSource Setting Facility Modifier None Typical Low $8,317.64 Median $11,481.54 Typical High $18,620.87 | Facility | None | $8,317.64 | $11,481.54 | $18,620.87 |
CareSource Setting Professional Modifier None Typical Low $12,882.50 Median $16,218.10 Typical High $20,417.38 | Professional | None | $12,882.50 | $16,218.10 | $20,417.38 |
Cigna Setting Facility Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $18,620.87 | Facility | None | $9,120.11 | $9,120.11 | $18,620.87 |
Cigna Setting Professional Modifier None Typical Low $6,606.93 Median $9,120.11 Typical High $66,069.34 | Professional | None | $6,606.93 | $9,120.11 | $66,069.34 |
Molina Setting Professional Modifier None Typical Low $8,128.31 Median $8,128.31 Typical High $9,772.37 | Professional | None | $8,128.31 | $8,128.31 | $9,772.37 |
United Setting Facility Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $6,165.95 | Facility | None | $5,128.61 | $5,128.61 | $6,165.95 |
United Setting Professional Modifier None Typical Low $4,365.16 Median $6,456.54 Typical High $9,332.54 | Professional | None | $4,365.16 | $6,456.54 | $9,332.54 |
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 $2,754.23 Median $3,388.44 Typical High $6,165.95 | Professional | 52 · Reduced service | $2,754.23 | $3,388.44 | $6,165.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,096.48 Median $1,380.38 Typical High $2,454.71 | Professional | 53 · Discontinued | $1,096.48 | $1,380.38 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $812.83 Median $1,023.29 Typical High $1,819.70 | Professional | 55 · Aftercare only | $812.83 | $1,023.29 | $1,819.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $549.54 Median $691.83 Typical High $1,230.27 | Professional | 56 · Pre-op care only | $549.54 | $691.83 | $1,230.27 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | RR · Rental | $741.31 | $741.31 | $741.31 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Professional | UE · Used equipment | $5,623.41 | $5,623.41 | $5,623.41 |
Where Kentucky sits
The same service costs 2.5 times more in Montana 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· 37th of 51
$7,413
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.