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 $21.88 Median $41.69 Typical High $47.86 | Facility | None | $21.88 | $41.69 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $47.86 Typical High $66.07 | Professional | None | $41.69 | $47.86 | $66.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.88 Median $43.65 Typical High $43.65 | Professional | None | $33.88 | $43.65 | $43.65 |
CareSource Setting Facility Modifier None Typical Low $51.29 Median $57.54 Typical High $79.43 | Facility | None | $51.29 | $57.54 | $79.43 |
CareSource Setting Professional Modifier None Typical Low $66.07 Median $75.86 Typical High $109.65 | Professional | None | $66.07 | $75.86 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $44.67 Typical High $331.13 | Professional | None | $28.84 | $44.67 | $331.13 |
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 $29.51 Typical High $47.86 | Professional | None | $10.00 | $29.51 | $47.86 |
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 $20.89 Median $23.99 Typical High $33.11 | Professional | 52 · Reduced service | $20.89 | $23.99 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $9.55 Typical High $13.18 | Professional | 53 · Discontinued | $8.51 | $9.55 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $7.08 Typical High $9.77 | Professional | 55 · Aftercare only | $6.31 | $7.08 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.79 Typical High $6.61 | Professional | 56 · Pre-op care only | $4.17 | $4.79 | $6.61 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | UE · Used equipment | $25.70 | $25.70 | $25.70 |
Where Kentucky sits
The same service costs 2.8 times more in Hawaii than in Utah. 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· 28th of 51
$43.65
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.