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 $8.51 Median $13.18 Typical High $15.49 | Facility | None | $8.51 | $13.18 | $15.49 |
Aetna Setting Professional Modifier None Typical Low $10.96 Median $13.18 Typical High $30.20 | Professional | None | $10.96 | $13.18 | $30.20 |
Ambetter Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $26.30 | Professional | None | $19.95 | $19.95 | $26.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $19.05 Median $30.90 Typical High $32.36 | Facility | None | $19.05 | $30.90 | $32.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.30 Median $14.13 Typical High $20.42 | Professional | None | $12.30 | $14.13 | $20.42 |
CareSource Setting Facility Modifier None Typical Low $19.50 Median $26.92 Typical High $43.65 | Facility | None | $19.50 | $26.92 | $43.65 |
CareSource Setting Professional Modifier None Typical Low $30.20 Median $38.02 Typical High $47.86 | Professional | None | $30.20 | $38.02 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $41.69 | Facility | None | $16.22 | $16.22 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $16.22 Typical High $131.83 | Professional | None | $12.02 | $16.22 | $131.83 |
Molina Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $22.91 | Professional | None | $19.05 | $19.05 | $22.91 |
United Setting Facility Modifier None Typical Low $12.88 Median $12.88 Typical High $15.49 | Facility | None | $12.88 | $12.88 | $15.49 |
United Setting Professional Modifier None Typical Low $10.00 Median $15.14 Typical High $19.95 | Professional | None | $10.00 | $15.14 | $19.95 |
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 $5.50 Median $6.61 Typical High $15.14 | Professional | 52 · Reduced service | $5.50 | $6.61 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.19 Median $2.63 Typical High $6.03 | Professional | 53 · Discontinued | $2.19 | $2.63 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.62 Median $1.95 Typical High $4.47 | Professional | 55 · Aftercare only | $1.62 | $1.95 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.10 Median $1.32 Typical High $3.02 | Professional | 56 · Pre-op care only | $1.10 | $1.32 | $3.02 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | RR · Rental | $1.82 | $1.82 | $1.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | UE · Used equipment | $13.49 | $13.49 | $13.49 |
Where Kentucky sits
The same service costs 3.0 times more in Hawaii 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· 43rd of 51
$14.13
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.