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 $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $45.71 Typical High $85.11 | Professional | None | $42.66 | $45.71 | $85.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $56.23 Median $89.13 Typical High $95.50 | Facility | None | $56.23 | $89.13 | $95.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $41.69 Median $46.77 Typical High $60.26 | Professional | None | $41.69 | $46.77 | $60.26 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | UE · Used equipment | $35.48 | $35.48 | $35.48 |
CareSource Setting Facility Modifier None Typical Low $57.54 Median $79.43 Typical High $128.82 | Facility | None | $57.54 | $79.43 | $128.82 |
CareSource Setting Professional Modifier None Typical Low $89.13 Median $109.65 Typical High $141.25 | Professional | None | $89.13 | $109.65 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $123.03 | Facility | None | $69.18 | $69.18 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $69.18 Typical High $426.58 | Professional | None | $58.88 | $69.18 | $426.58 |
Molina Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $56.23 | Professional | None | $46.77 | $46.77 | $56.23 |
United Setting Professional Modifier None Typical Low $29.51 Median $43.65 Typical High $60.26 | Professional | None | $29.51 | $43.65 | $60.26 |
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 $21.38 Median $22.91 Typical High $42.66 | Professional | 52 · Reduced service | $21.38 | $22.91 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $9.12 Typical High $16.98 | Professional | 53 · Discontinued | $8.51 | $9.12 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.92 Typical High $12.88 | Professional | 55 · Aftercare only | $6.46 | $6.92 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.57 Typical High $8.51 | Professional | 56 · Pre-op care only | $4.27 | $4.57 | $8.51 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | RR · Rental | $4.79 | $4.79 | $4.79 |
Where Kentucky sits
The same service costs 2.0 times more in Montana than in South Carolina. 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· 50th of 51
$46.77
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.