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 $47.86 Median $58.88 Typical High $58.88 | Facility | None | $47.86 | $58.88 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $58.88 Typical High $112.20 | Professional | None | $48.98 | $58.88 | $112.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $72.44 Median $117.49 Typical High $123.03 | Facility | None | $72.44 | $117.49 | $123.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $61.66 Typical High $77.62 | Professional | None | $53.70 | $61.66 | $77.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | UE · Used equipment | $45.71 | $45.71 | $45.71 |
CareSource Setting Facility Modifier None Typical Low $74.13 Median $102.33 Typical High $165.96 | Facility | None | $74.13 | $102.33 | $165.96 |
CareSource Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $181.97 | Professional | None | $114.82 | $144.54 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $158.49 | Facility | None | $91.20 | $91.20 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $91.20 Typical High $562.34 | Professional | None | $77.62 | $91.20 | $562.34 |
Molina Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $74.13 | Professional | None | $61.66 | $61.66 | $74.13 |
United Setting Professional Modifier None Typical Low $38.02 Median $57.54 Typical High $77.62 | Professional | None | $38.02 | $57.54 | $77.62 |
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 $24.55 Median $29.51 Typical High $54.95 | Professional | 52 · Reduced service | $24.55 | $29.51 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $11.75 Typical High $22.39 | Professional | 53 · Discontinued | $9.77 | $11.75 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $8.91 Typical High $16.60 | Professional | 55 · Aftercare only | $7.24 | $8.91 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.89 Typical High $11.22 | Professional | 56 · Pre-op care only | $4.79 | $5.89 | $11.22 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | RR · Rental | $6.17 | $6.17 | $6.17 |
Where Kentucky sits
The same service costs 1.9 times more in Montana than in Virginia. 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· 49th of 51
$61.66
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.