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 $14.79 Median $26.30 Typical High $28.18 | Facility | None | $14.79 | $26.30 | $28.18 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $28.18 Typical High $40.74 | Professional | None | $26.30 | $28.18 | $40.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.95 Median $26.92 Typical High $27.54 | Professional | None | $19.95 | $26.92 | $27.54 |
CareSource Setting Facility Modifier None Typical Low $35.48 Median $39.81 Typical High $54.95 | Facility | None | $35.48 | $39.81 | $54.95 |
CareSource Setting Professional Modifier None Typical Low $40.74 Median $48.98 Typical High $67.61 | Professional | None | $40.74 | $48.98 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $28.84 Typical High $229.09 | Professional | None | $19.95 | $28.84 | $229.09 |
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 $18.62 Typical High $32.36 | Professional | None | $10.00 | $18.62 | $32.36 |
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 $13.18 Median $14.13 Typical High $20.42 | Professional | 52 · Reduced service | $13.18 | $14.13 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.62 Typical High $8.13 | Professional | 53 · Discontinued | $5.25 | $5.62 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $4.27 Typical High $6.17 | Professional | 55 · Aftercare only | $3.89 | $4.27 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.82 Typical High $4.07 | Professional | 56 · Pre-op care only | $2.63 | $2.82 | $4.07 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | UE · Used equipment | $15.14 | $15.14 | $15.14 |
Where Kentucky sits
The same service costs 3.2 times more in Montana than in Indiana. 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· 35th of 51
$26.92
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.