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 $32.36 Median $56.23 Typical High $63.10 | Facility | None | $32.36 | $56.23 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $63.10 Typical High $89.13 | Professional | None | $56.23 | $63.10 | $89.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $45.71 Median $58.88 Typical High $58.88 | Professional | None | $45.71 | $58.88 | $58.88 |
CareSource Setting Facility Modifier None Typical Low $75.86 Median $87.10 Typical High $120.23 | Facility | None | $75.86 | $87.10 | $120.23 |
CareSource Setting Professional Modifier None Typical Low $89.13 Median $107.15 Typical High $147.91 | Professional | None | $89.13 | $107.15 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $61.66 Typical High $489.78 | Professional | None | $43.65 | $61.66 | $489.78 |
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 $39.81 Typical High $63.10 | Professional | None | $10.00 | $39.81 | $63.10 |
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 $28.18 Median $31.62 Typical High $44.67 | Professional | 52 · Reduced service | $28.18 | $31.62 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $12.59 Typical High $17.78 | Professional | 53 · Discontinued | $11.48 | $12.59 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $9.55 Typical High $13.18 | Professional | 55 · Aftercare only | $8.51 | $9.55 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.31 Typical High $8.91 | Professional | 56 · Pre-op care only | $5.62 | $6.31 | $8.91 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | UE · Used equipment | $33.88 | $33.88 | $33.88 |
Where Kentucky sits
The same service costs 3.5 times more in Hawaii than in New York. 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· 30th of 51
$58.88
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.