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 $21.38 Median $38.02 Typical High $48.98 | Facility | None | $21.38 | $38.02 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $48.98 Typical High $64.57 | Professional | None | $38.02 | $48.98 | $64.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $27.54 Median $50.12 Typical High $51.29 | Professional | None | $27.54 | $50.12 | $51.29 |
CareSource Setting Facility Modifier None Typical Low $50.12 Median $57.54 Typical High $79.43 | Facility | None | $50.12 | $57.54 | $79.43 |
CareSource Setting Professional Modifier None Typical Low $69.18 Median $89.13 Typical High $125.89 | Professional | None | $69.18 | $89.13 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $44.67 Typical High $323.59 | Professional | None | $28.84 | $44.67 | $323.59 |
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 $34.67 Typical High $50.12 | Professional | None | $10.00 | $34.67 | $50.12 |
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 $19.05 Median $24.55 Typical High $32.36 | Professional | 52 · Reduced service | $19.05 | $24.55 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $9.77 Typical High $12.88 | Professional | 53 · Discontinued | $7.76 | $9.77 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $7.24 Typical High $9.55 | Professional | 55 · Aftercare only | $5.75 | $7.24 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $4.90 Typical High $6.46 | Professional | 56 · Pre-op care only | $3.89 | $4.90 | $6.46 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | UE · Used equipment | $20.42 | $20.42 | $20.42 |
Where Kentucky sits
The same service costs 2.6 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· 17th of 51
$50.12
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.