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 $218.78 Median $346.74 Typical High $346.74 | Facility | None | $218.78 | $346.74 | $346.74 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $346.74 Typical High $512.86 | Professional | None | $218.78 | $346.74 | $512.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $457.09 | Professional | None | $309.03 | $363.08 | $457.09 |
CareSource Setting Facility Modifier None Typical Low $436.52 Median $602.56 Typical High $977.24 | Facility | None | $436.52 | $602.56 | $977.24 |
CareSource Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $1,071.52 | Professional | None | $660.69 | $831.76 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $933.25 | Facility | None | $371.54 | $371.54 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $3,019.95 | Professional | None | $316.23 | $371.54 | $3,019.95 |
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 $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $223.87 Median $331.13 Typical High $457.09 | Professional | None | $223.87 | $331.13 | $457.09 |
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 $109.65 Median $173.78 Typical High $257.04 | Professional | 52 · Reduced service | $109.65 | $173.78 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $69.18 Typical High $102.33 | Professional | 53 · Discontinued | $43.65 | $69.18 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $52.48 Typical High $75.86 | Professional | 55 · Aftercare only | $33.11 | $52.48 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $34.67 Typical High $51.29 | Professional | 56 · Pre-op care only | $21.88 | $34.67 | $51.29 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $251.19 Median $251.19 Typical High $416.87 | Professional | UE · Used equipment | $251.19 | $251.19 | $416.87 |
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· 37th of 51
$347
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.