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 $138.04 Median $204.17 Typical High $218.78 | Facility | None | $138.04 | $204.17 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $204.17 Typical High $229.09 | Professional | None | $123.03 | $204.17 | $229.09 |
Ambetter Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $251.19 Median $407.38 Typical High $426.58 | Facility | None | $251.19 | $407.38 | $426.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $295.12 | Professional | None | $204.17 | $275.42 | $295.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | UE · Used equipment | $208.93 | $208.93 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $257.04 Median $354.81 Typical High $575.44 | Facility | None | $257.04 | $354.81 | $575.44 |
CareSource Setting Professional Modifier None Typical Low $398.11 Median $489.78 Typical High $630.96 | Professional | None | $398.11 | $489.78 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $302.00 Typical High $575.44 | Facility | None | $295.12 | $302.00 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $295.12 Typical High $2,089.30 | Professional | None | $213.80 | $295.12 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $302.00 | Professional | None | $251.19 | $251.19 | $302.00 |
United Setting Facility Modifier None Typical Low $186.21 Median $229.09 Typical High $251.19 | Facility | None | $186.21 | $229.09 | $251.19 |
United Setting Professional Modifier None Typical Low $154.88 Median $199.53 Typical High $331.13 | Professional | None | $154.88 | $199.53 | $331.13 |
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 $83.18 Median $102.33 Typical High $199.53 | Professional | 52 · Reduced service | $83.18 | $102.33 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $41.69 Typical High $79.43 | Professional | 53 · Discontinued | $33.88 | $41.69 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $30.90 Typical High $58.88 | Professional | 55 · Aftercare only | $25.12 | $30.90 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $20.42 Typical High $39.81 | Professional | 56 · Pre-op care only | $16.98 | $20.42 | $39.81 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | RR · Rental | $27.54 | $27.54 | $27.54 |
Where Kentucky sits
The same service costs 2.5 times more in Hawaii than in Washington, DC. 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· 32nd of 51
$269
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.