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 $22.39 Median $38.02 Typical High $39.81 | Facility | None | $22.39 | $38.02 | $39.81 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $39.81 Typical High $60.26 | Professional | None | $38.02 | $39.81 | $60.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.92 Median $40.74 Typical High $40.74 | Professional | None | $26.92 | $40.74 | $40.74 |
CareSource Setting Facility Modifier None Typical Low $53.70 Median $60.26 Typical High $83.18 | Facility | None | $53.70 | $60.26 | $83.18 |
CareSource Setting Professional Modifier None Typical Low $61.66 Median $74.13 Typical High $102.33 | Professional | None | $61.66 | $74.13 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $42.66 Typical High $338.84 | Professional | None | $30.20 | $42.66 | $338.84 |
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 $12.02 Median $27.54 Typical High $47.86 | Professional | None | $12.02 | $27.54 | $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 $19.05 Median $19.50 Typical High $30.20 | Professional | 52 · Reduced service | $19.05 | $19.50 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.94 Typical High $12.02 | Professional | 53 · Discontinued | $7.59 | $7.94 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.89 Typical High $8.91 | Professional | 55 · Aftercare only | $5.62 | $5.89 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.98 Typical High $6.03 | Professional | 56 · Pre-op care only | $3.80 | $3.98 | $6.03 |
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 2.8 times more in Montana than in Ohio. 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· 35th of 51
$40.74
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.