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 $69.18 | Facility | None | $32.36 | $56.23 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $69.18 Typical High $87.10 | Professional | None | $56.23 | $69.18 | $87.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $48.98 Median $57.54 Typical High $58.88 | Professional | None | $48.98 | $57.54 | $58.88 |
CareSource Setting Facility Modifier None Typical Low $75.86 Median $85.11 Typical High $120.23 | Facility | None | $75.86 | $85.11 | $120.23 |
CareSource Setting Professional Modifier None Typical Low $87.10 Median $104.71 Typical High $144.54 | Professional | None | $87.10 | $104.71 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $61.66 Typical High $501.19 | Professional | None | $42.66 | $61.66 | $501.19 |
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 $39.81 Typical High $67.61 | Professional | None | $10.00 | $39.81 | $67.61 |
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 $34.67 Typical High $43.65 | Professional | 52 · Reduced service | $28.18 | $34.67 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $13.80 Typical High $17.78 | Professional | 53 · Discontinued | $11.22 | $13.80 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $10.47 Typical High $13.18 | Professional | 55 · Aftercare only | $8.51 | $10.47 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.92 Typical High $8.71 | Professional | 56 · Pre-op care only | $5.62 | $6.92 | $8.71 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | UE · Used equipment | $37.15 | $37.15 | $37.15 |
Where Kentucky sits
The same service costs 3.2 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· 37th of 51
$57.54
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.