How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $3.16 Median $3.63 Typical High $8.13 | Facility | None | $3.16 | $3.63 | $8.13 |
Aetna Setting Professional Modifier None Typical Low $3.16 Median $3.47 Typical High $3.63 | Professional | None | $3.16 | $3.47 | $3.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.34 Median $3.39 Typical High $3.89 | Professional | None | $2.34 | $3.39 | $3.89 |
CareSource Setting Facility Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Facility | None | $5.75 | $5.75 | $5.75 |
CareSource Setting Professional Modifier None Typical Low $6.03 Median $7.08 Typical High $9.12 | Professional | None | $6.03 | $7.08 | $9.12 |
Cigna Setting Facility Modifier None Typical Low $7.94 Median $7.94 Typical High $7.94 | Facility | None | $7.94 | $7.94 | $7.94 |
Cigna Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $28.18 | Professional | None | $2.34 | $2.34 | $28.18 |
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 $1.91 Median $2.51 Typical High $3.31 | Professional | None | $1.91 | $2.51 | $3.31 |
6 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 $1.58 Median $1.70 Typical High $1.82 | Professional | 52 · Reduced service | $1.58 | $1.70 | $1.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.63 Median $0.71 Typical High $0.72 | Professional | 53 · Discontinued | $0.63 | $0.71 | $0.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.34 Median $2.57 Typical High $2.75 | Professional | 54 · Surgery only | $2.34 | $2.57 | $2.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.47 Median $0.52 Typical High $0.55 | Professional | 55 · Aftercare only | $0.47 | $0.52 | $0.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.31 Median $0.34 Typical High $0.36 | Professional | 56 · Pre-op care only | $0.31 | $0.34 | $0.36 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.24 Median $3.24 Typical High $4.79 | Professional | UE · Used equipment | $3.24 | $3.24 | $4.79 |
Where Kentucky sits
The same service costs 3.0 times more in Rhode Island 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· 33rd of 51
$3.39
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.