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 $87.10 Median $141.25 Typical High $141.25 | Facility | None | $87.10 | $141.25 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $141.25 Typical High $245.47 | Professional | None | $87.10 | $141.25 | $245.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $173.78 Median $281.84 Typical High $295.12 | Facility | None | $173.78 | $281.84 | $295.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $186.21 | Professional | None | $128.82 | $144.54 | $186.21 |
CareSource Setting Facility Modifier None Typical Low $177.83 Median $245.47 Typical High $398.11 | Facility | None | $177.83 | $245.47 | $398.11 |
CareSource Setting Professional Modifier None Typical Low $275.42 Median $338.84 Typical High $436.52 | Professional | None | $275.42 | $338.84 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $169.82 Typical High $380.19 | Facility | None | $107.15 | $169.82 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $169.82 Typical High $1,348.96 | Professional | None | $125.89 | $169.82 | $1,348.96 |
Molina Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $208.93 | Professional | None | $173.78 | $173.78 | $208.93 |
United Setting Facility Modifier None Typical Low $112.20 Median $125.89 Typical High $134.90 | Facility | None | $112.20 | $125.89 | $134.90 |
United Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $213.80 | Professional | None | $107.15 | $138.04 | $213.80 |
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 $52.48 Median $70.79 Typical High $123.03 | Professional | 52 · Reduced service | $52.48 | $70.79 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $28.18 Typical High $48.98 | Professional | 53 · Discontinued | $20.89 | $28.18 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $21.38 Typical High $37.15 | Professional | 55 · Aftercare only | $15.85 | $21.38 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $14.13 Typical High $24.55 | Professional | 56 · Pre-op care only | $10.47 | $14.13 | $24.55 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | RR · Rental | $18.20 | $18.20 | $18.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | UE · Used equipment | $134.90 | $134.90 | $134.90 |
Where Kentucky sits
The same service costs 2.7 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· 44th of 51
$145
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.