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 $16.60 Median $28.84 Typical High $28.84 | Facility | None | $16.60 | $28.84 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $45.71 | Professional | None | $28.84 | $28.84 | $45.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.89 Median $29.51 Typical High $30.20 | Professional | None | $20.89 | $29.51 | $30.20 |
CareSource Setting Facility Modifier None Typical Low $38.90 Median $43.65 Typical High $61.66 | Facility | None | $38.90 | $43.65 | $61.66 |
CareSource Setting Professional Modifier None Typical Low $45.71 Median $53.70 Typical High $74.13 | Professional | None | $45.71 | $53.70 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $22.39 Median $31.62 Typical High $251.19 | Professional | None | $22.39 | $31.62 | $251.19 |
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 $20.42 Typical High $34.67 | Professional | None | $10.00 | $20.42 | $34.67 |
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 $14.45 Median $14.45 Typical High $22.39 | Professional | 52 · Reduced service | $14.45 | $14.45 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $9.12 | Professional | 53 · Discontinued | $5.75 | $5.75 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $6.76 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $4.47 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $4.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | UE · Used equipment | $15.49 | $15.49 | $15.49 |
Where Kentucky sits
The same service costs 3.3 times more in Montana than in Missouri. 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
$29.51
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.