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 $173.78 Median $275.42 Typical High $275.42 | Facility | None | $173.78 | $275.42 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $275.42 Typical High $398.11 | Professional | None | $223.87 | $275.42 | $398.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $281.84 Typical High $354.81 | Professional | None | $245.47 | $281.84 | $354.81 |
CareSource Setting Facility Modifier None Typical Low $338.84 Median $478.63 Typical High $758.58 | Facility | None | $338.84 | $478.63 | $758.58 |
CareSource Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $851.14 | Professional | None | $524.81 | $660.69 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $724.44 | Facility | None | $416.87 | $416.87 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $2,398.83 | Professional | None | $354.81 | $416.87 | $2,398.83 |
Molina Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
United Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
United Setting Professional Modifier None Typical Low $173.78 Median $263.03 Typical High $363.08 | Professional | None | $173.78 | $263.03 | $363.08 |
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 $112.20 Median $138.04 Typical High $199.53 | Professional | 52 · Reduced service | $112.20 | $138.04 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $54.95 Typical High $79.43 | Professional | 53 · Discontinued | $44.67 | $54.95 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $40.74 Typical High $60.26 | Professional | 55 · Aftercare only | $33.88 | $40.74 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $27.54 Typical High $39.81 | Professional | 56 · Pre-op care only | $22.39 | $27.54 | $39.81 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $199.53 Median $199.53 Typical High $331.13 | Professional | UE · Used equipment | $199.53 | $199.53 | $331.13 |
Where Kentucky sits
The same service costs 2.5 times more in Montana than in New York. 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
$282
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.