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 $87.10 Median $128.82 Typical High $144.54 | Facility | None | $87.10 | $128.82 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $128.82 Typical High $199.53 | Professional | None | $112.20 | $128.82 | $199.53 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $141.25 Typical High $186.21 | Professional | None | $123.03 | $141.25 | $186.21 |
CareSource Setting Facility Modifier None Typical Low $177.83 Median $251.19 Typical High $398.11 | Facility | None | $177.83 | $251.19 | $398.11 |
CareSource Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $446.68 | Professional | None | $275.42 | $346.74 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $380.19 | Facility | None | $194.98 | $194.98 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $194.98 Typical High $1,202.26 | Professional | None | $165.96 | $194.98 | $1,202.26 |
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 Professional Modifier None Typical Low $91.20 Median $138.04 Typical High $181.97 | Professional | None | $91.20 | $138.04 | $181.97 |
3 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 $16.98 Median $19.50 Typical High $30.20 | Professional | 55 · Aftercare only | $16.98 | $19.50 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $12.88 Typical High $19.95 | Professional | 56 · Pre-op care only | $11.22 | $12.88 | $19.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $93.33 Median $93.33 Typical High $173.78 | Professional | UE · Used equipment | $93.33 | $93.33 | $173.78 |
Where Kentucky sits
The same service costs 2.6 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
$141
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.