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 $891.25 Median $1,380.38 Typical High $1,412.54 | Facility | None | $891.25 | $1,380.38 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $1,995.26 | Professional | None | $1,148.15 | $1,380.38 | $1,995.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,412.54 Typical High $1,819.70 | Professional | None | $1,258.93 | $1,412.54 | $1,819.70 |
CareSource Setting Facility Modifier None Typical Low $1,778.28 Median $2,454.71 Typical High $3,890.45 | Facility | None | $1,778.28 | $2,454.71 | $3,890.45 |
CareSource Setting Professional Modifier None Typical Low $2,691.53 Median $3,388.44 Typical High $4,365.16 | Professional | None | $2,691.53 | $3,388.44 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $3,801.89 | Facility | None | $1,479.11 | $1,479.11 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $12,022.64 | Professional | None | $1,258.93 | $1,479.11 | $12,022.64 |
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 $912.01 Median $1,348.96 Typical High $1,819.70 | Professional | None | $912.01 | $1,348.96 | $1,819.70 |
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 $575.44 Median $691.83 Typical High $1,000.00 | Professional | 52 · Reduced service | $575.44 | $691.83 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $275.42 Typical High $398.11 | Professional | 53 · Discontinued | $229.09 | $275.42 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $208.93 Typical High $302.00 | Professional | 55 · Aftercare only | $173.78 | $208.93 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $138.04 Typical High $199.53 | Professional | 56 · Pre-op care only | $114.82 | $138.04 | $199.53 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,000.00 Median $1,071.52 Typical High $1,412.54 | Professional | UE · Used equipment | $1,000.00 | $1,071.52 | $1,412.54 |
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· 39th of 51
$1,380
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.