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 $31.62 Median $39.81 Typical High $39.81 | Facility | None | $31.62 | $39.81 | $39.81 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $39.81 Typical High $74.13 | Professional | None | $32.36 | $39.81 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $48.98 Median $77.62 Typical High $81.28 | Facility | None | $48.98 | $77.62 | $81.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $35.48 Median $41.69 Typical High $51.29 | Professional | None | $35.48 | $41.69 | $51.29 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | RR · Rental | $4.27 | $4.27 | $4.27 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | UE · Used equipment | $31.62 | $31.62 | $31.62 |
CareSource Setting Facility Modifier None Typical Low $50.12 Median $69.18 Typical High $112.20 | Facility | None | $50.12 | $69.18 | $112.20 |
CareSource Setting Professional Modifier None Typical Low $75.86 Median $95.50 Typical High $123.03 | Professional | None | $75.86 | $95.50 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $107.15 | Facility | None | $43.65 | $43.65 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $43.65 Typical High $371.54 | Professional | None | $37.15 | $43.65 | $371.54 |
Molina Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $57.54 | Professional | None | $47.86 | $47.86 | $57.54 |
United Setting Professional Modifier None Typical Low $25.70 Median $38.02 Typical High $52.48 | Professional | None | $25.70 | $38.02 | $52.48 |
2 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 55 · Aftercare only Typical Low $4.90 Median $5.89 Typical High $11.22 | Professional | 55 · Aftercare only | $4.90 | $5.89 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.98 Typical High $7.41 | Professional | 56 · Pre-op care only | $3.24 | $3.98 | $7.41 |
Where Kentucky sits
The same service costs 2.2 times more in Montana than in West 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· 38th of 51
$41.69
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.