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 $151.36 Median $218.78 Typical High $229.09 | Facility | None | $151.36 | $218.78 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $218.78 Typical High $354.81 | Professional | None | $186.21 | $218.78 | $354.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $295.12 | Professional | None | $204.17 | $251.19 | $295.12 |
CareSource Setting Facility Modifier None Typical Low $288.40 Median $398.11 Typical High $630.96 | Facility | None | $288.40 | $398.11 | $630.96 |
CareSource Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $707.95 | Professional | None | $436.52 | $549.54 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $602.56 | Facility | None | $371.54 | $371.54 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $2,137.96 | Professional | None | $316.23 | $354.81 | $2,137.96 |
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 $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
United Setting Professional Modifier None Typical Low $144.54 Median $218.78 Typical High $323.59 | Professional | None | $144.54 | $218.78 | $323.59 |
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 $93.33 Median $109.65 Typical High $177.83 | Professional | 52 · Reduced service | $93.33 | $109.65 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $43.65 Typical High $70.79 | Professional | 53 · Discontinued | $37.15 | $43.65 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $33.11 Typical High $53.70 | Professional | 55 · Aftercare only | $28.18 | $33.11 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $21.88 Typical High $35.48 | Professional | 56 · Pre-op care only | $18.62 | $21.88 | $35.48 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $158.49 Median $190.55 Typical High $331.13 | Professional | UE · Used equipment | $158.49 | $190.55 | $331.13 |
Where Kentucky sits
The same service costs 3.4 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
$251
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.