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 $0.45 Median $0.45 Typical High $0.45 | Facility | None | $0.45 | $0.45 | $0.45 |
Aetna Setting Professional Modifier None Typical Low $0.45 Median $0.45 Typical High $0.46 | Professional | None | $0.45 | $0.45 | $0.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.55 Median $0.65 Typical High $0.65 | Facility | None | $0.55 | $0.65 | $0.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.47 Median $0.55 Typical High $0.55 | Professional | None | $0.47 | $0.55 | $0.55 |
CareSource Setting Facility Modifier None Typical Low $0.56 Median $0.56 Typical High $0.85 | Facility | None | $0.56 | $0.56 | $0.85 |
CareSource Setting Professional Modifier None Typical Low $0.54 Median $0.56 Typical High $0.79 | Professional | None | $0.54 | $0.56 | $0.79 |
Cigna Setting Facility Modifier None Typical Low $0.54 Median $85.11 Typical High $85.11 | Facility | None | $0.54 | $85.11 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $0.48 Median $0.48 Typical High $2.51 | Professional | None | $0.48 | $0.48 | $2.51 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
United Setting Professional Modifier None Typical Low $0.42 Median $0.47 Typical High $0.47 | Professional | None | $0.42 | $0.47 | $0.47 |
4 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 $0.23 Median $0.23 Typical High $0.23 | Professional | 52 · Reduced service | $0.23 | $0.23 | $0.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 53 · Discontinued | $0.09 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 55 · Aftercare only | $0.07 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.05 |
Where Kentucky sits
The same service costs 2.3 times more in Montana than in Michigan. 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· 40th of 51
$0.48
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.