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 $48.98 Median $79.43 Typical High $79.43 | Facility | None | $48.98 | $79.43 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $79.43 Typical High $147.91 | Professional | None | $48.98 | $79.43 | $147.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $97.72 Median $154.88 Typical High $162.18 | Facility | None | $97.72 | $154.88 | $162.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $81.28 Typical High $102.33 | Professional | None | $70.79 | $81.28 | $102.33 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | RR · Rental | $10.23 | $10.23 | $10.23 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | UE · Used equipment | $75.86 | $75.86 | $75.86 |
CareSource Setting Facility Modifier None Typical Low $100.00 Median $138.04 Typical High $218.78 | Facility | None | $100.00 | $138.04 | $218.78 |
CareSource Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $245.47 | Professional | None | $151.36 | $190.55 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $208.93 | Facility | None | $97.72 | $97.72 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $97.72 Typical High $741.31 | Professional | None | $72.44 | $97.72 | $741.31 |
Molina Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $109.65 | Professional | None | $91.20 | $91.20 | $109.65 |
United Setting Professional Modifier None Typical Low $58.88 Median $75.86 Typical High $120.23 | Professional | None | $58.88 | $75.86 | $120.23 |
2 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 55 · Aftercare only Typical Low $9.77 Median $11.75 Typical High $22.39 | Professional | 55 · Aftercare only | $9.77 | $11.75 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $7.94 Typical High $14.79 | Professional | 56 · Pre-op care only | $6.46 | $7.94 | $14.79 |
Where Kentucky sits
The same service costs 4.2 times more in Kansas 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
$81.28
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.