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 $19.50 Median $33.88 Typical High $36.31 | Facility | None | $19.50 | $33.88 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $36.31 Typical High $53.70 | Professional | None | $33.88 | $36.31 | $53.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $24.55 Median $38.02 Typical High $38.02 | Professional | None | $24.55 | $38.02 | $38.02 |
CareSource Setting Facility Modifier None Typical Low $46.77 Median $52.48 Typical High $72.44 | Facility | None | $46.77 | $52.48 | $72.44 |
CareSource Setting Professional Modifier None Typical Low $57.54 Median $66.07 Typical High $95.50 | Professional | None | $57.54 | $66.07 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $39.81 Typical High $302.00 | Professional | None | $26.30 | $39.81 | $302.00 |
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 $25.70 Typical High $38.90 | Professional | None | $10.00 | $25.70 | $38.90 |
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 $16.98 Median $18.20 Typical High $26.92 | Professional | 52 · Reduced service | $16.98 | $18.20 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $7.41 Typical High $10.96 | Professional | 53 · Discontinued | $6.92 | $7.41 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.50 Typical High $8.13 | Professional | 55 · Aftercare only | $5.13 | $5.50 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.63 Typical High $5.37 | Professional | 56 · Pre-op care only | $3.39 | $3.63 | $5.37 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | UE · Used equipment | $18.20 | $18.20 | $18.20 |
Where Kentucky sits
The same service costs 3.3 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· 32nd of 51
$38.02
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.