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 $14,125.38 Median $20,417.38 Typical High $24,547.09 | Facility | None | $14,125.38 | $20,417.38 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $14,125.38 Median $22,908.68 Typical High $35,481.34 | Professional | None | $14,125.38 | $22,908.68 | $35,481.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $25,118.86 Median $39,810.72 Typical High $41,686.94 | Facility | None | $25,118.86 | $39,810.72 | $41,686.94 |
Anthem BCBS Setting Professional Modifier None Typical Low $18,197.01 Median $23,442.29 Typical High $26,302.68 | Professional | None | $18,197.01 | $23,442.29 | $26,302.68 |
CareSource Setting Facility Modifier None Typical Low $25,703.96 Median $35,481.34 Typical High $56,234.13 | Facility | None | $25,703.96 | $35,481.34 | $56,234.13 |
CareSource Setting Professional Modifier None Typical Low $38,904.51 Median $48,977.88 Typical High $63,095.73 | Professional | None | $38,904.51 | $48,977.88 | $63,095.73 |
Cigna Setting Facility Modifier None Typical Low $30,199.52 Median $30,199.52 Typical High $60,255.96 | Facility | None | $30,199.52 | $30,199.52 | $60,255.96 |
Cigna Setting Professional Modifier None Typical Low $22,387.21 Median $30,199.52 Typical High $213,796.21 | Professional | None | $22,387.21 | $30,199.52 | $213,796.21 |
Molina Setting Professional Modifier None Typical Low $24,547.09 Median $24,547.09 Typical High $29,512.09 | Professional | None | $24,547.09 | $24,547.09 | $29,512.09 |
United Setting Professional Modifier None Typical Low $13,489.63 Median $19,498.45 Typical High $30,199.52 | Professional | None | $13,489.63 | $19,498.45 | $30,199.52 |
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 $8,317.64 Median $11,481.54 Typical High $17,782.79 | Professional | 52 · Reduced service | $8,317.64 | $11,481.54 | $17,782.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3,311.31 Median $4,570.88 Typical High $7,079.46 | Professional | 53 · Discontinued | $3,311.31 | $4,570.88 | $7,079.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2,511.89 Median $3,467.37 Typical High $5,370.32 | Professional | 55 · Aftercare only | $2,511.89 | $3,467.37 | $5,370.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1,659.59 Median $2,290.87 Typical High $3,548.13 | Professional | 56 · Pre-op care only | $1,659.59 | $2,290.87 | $3,548.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | RR · Rental | $2,398.83 | $2,398.83 | $2,398.83 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $17,782.79 Median $17,782.79 Typical High $17,782.79 | Professional | UE · Used equipment | $17,782.79 | $17,782.79 | $17,782.79 |
Where Kentucky sits
The same service costs 2.1 times more in Hawaii than in New Jersey. 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· 41st of 51
$23,442
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.