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 $0.32 Median $0.39 Typical High $0.39 | Facility | None | $0.32 | $0.39 | $0.39 |
Aetna Setting Professional Modifier None Typical Low $0.32 Median $0.39 Typical High $0.56 | Professional | None | $0.32 | $0.39 | $0.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.48 Median $0.78 Typical High $0.81 | Facility | None | $0.48 | $0.78 | $0.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.35 Median $0.40 Typical High $0.62 | Professional | None | $0.35 | $0.40 | $0.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.38 Median $0.44 Typical High $0.59 | Professional | UE · Used equipment | $0.38 | $0.44 | $0.59 |
CareSource Setting Facility Modifier None Typical Low $0.49 Median $0.68 Typical High $1.10 | Facility | None | $0.49 | $0.68 | $1.10 |
CareSource Setting Professional Modifier None Typical Low $0.76 Median $0.93 Typical High $1.20 | Professional | None | $0.76 | $0.93 | $1.20 |
Cigna Setting Facility Modifier None Typical Low $0.42 Median $0.42 Typical High $1.05 | Facility | None | $0.42 | $0.42 | $1.05 |
Cigna Setting Professional Modifier None Typical Low $0.36 Median $0.42 Typical High $3.39 | Professional | None | $0.36 | $0.42 | $3.39 |
Molina Setting Professional Modifier None Typical Low $0.37 Median $0.37 Typical High $0.47 | Professional | None | $0.37 | $0.37 | $0.47 |
United Setting Professional Modifier None Typical Low $0.25 Median $0.37 Typical High $0.51 | Professional | None | $0.25 | $0.37 | $0.51 |
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 $0.16 Median $0.20 Typical High $0.28 | Professional | 52 · Reduced service | $0.16 | $0.20 | $0.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.06 Median $0.08 Typical High $0.11 | Professional | 53 · Discontinued | $0.06 | $0.08 | $0.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.06 Typical High $0.09 | Professional | 55 · Aftercare only | $0.05 | $0.06 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.04 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.03 | $0.04 | $0.06 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.05 Median $0.06 Typical High $0.06 | Professional | RR · Rental | $0.05 | $0.06 | $0.06 |
Where Kentucky sits
The same service costs 2.3 times more in Montana than in Hawaii. 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· 43rd of 51
$0.40
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.