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 $25.12 Median $44.67 Typical High $56.23 | Facility | None | $25.12 | $44.67 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $56.23 Typical High $70.79 | Professional | None | $44.67 | $56.23 | $70.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $46.77 Typical High $46.77 | Professional | None | $39.81 | $46.77 | $46.77 |
CareSource Setting Facility Modifier None Typical Low $60.26 Median $67.61 Typical High $95.50 | Facility | None | $60.26 | $67.61 | $95.50 |
CareSource Setting Professional Modifier None Typical Low $70.79 Median $83.18 Typical High $114.82 | Professional | None | $70.79 | $83.18 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $48.98 Typical High $389.05 | Professional | None | $33.88 | $48.98 | $389.05 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
United Setting Professional Modifier None Typical Low $10.00 Median $31.62 Typical High $54.95 | Professional | None | $10.00 | $31.62 | $54.95 |
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 $22.39 Median $27.54 Typical High $35.48 | Professional | 52 · Reduced service | $22.39 | $27.54 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $11.22 Typical High $14.13 | Professional | 53 · Discontinued | $8.91 | $11.22 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $8.32 Typical High $10.47 | Professional | 55 · Aftercare only | $6.76 | $8.32 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $5.62 Typical High $7.08 | Professional | 56 · Pre-op care only | $4.47 | $5.62 | $7.08 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | UE · Used equipment | $30.20 | $30.20 | $30.20 |
Where Kentucky sits
The same service costs 3.1 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· 31st of 51
$46.77
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.