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 $23.44 Median $39.81 Typical High $42.66 | Facility | None | $23.44 | $39.81 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $42.66 Typical High $63.10 | Professional | None | $39.81 | $42.66 | $63.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $28.84 Median $44.67 Typical High $44.67 | Professional | None | $28.84 | $44.67 | $44.67 |
CareSource Setting Facility Modifier None Typical Low $56.23 Median $63.10 Typical High $87.10 | Facility | None | $56.23 | $63.10 | $87.10 |
CareSource Setting Professional Modifier None Typical Low $67.61 Median $77.62 Typical High $112.20 | Professional | None | $67.61 | $77.62 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $46.77 Typical High $354.81 | Professional | None | $31.62 | $46.77 | $354.81 |
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 $30.20 Typical High $51.29 | Professional | None | $12.02 | $30.20 | $51.29 |
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 $19.95 Median $21.38 Typical High $31.62 | Professional | 52 · Reduced service | $19.95 | $21.38 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $8.71 Typical High $12.59 | Professional | 53 · Discontinued | $7.94 | $8.71 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.46 Typical High $9.55 | Professional | 55 · Aftercare only | $6.03 | $6.46 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.27 Typical High $6.31 | Professional | 56 · Pre-op care only | $3.98 | $4.27 | $6.31 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | UE · Used equipment | $21.38 | $21.38 | $21.38 |
Where Kentucky sits
The same service costs 2.8 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· 31st of 51
$44.67
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.