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 $25.12 Median $43.65 Typical High $47.86 | Facility | None | $25.12 | $43.65 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $47.86 Typical High $69.18 | Professional | None | $43.65 | $47.86 | $69.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $31.62 Median $48.98 Typical High $50.12 | Professional | None | $31.62 | $48.98 | $50.12 |
CareSource Setting Facility Modifier None Typical Low $58.88 Median $66.07 Typical High $93.33 | Facility | None | $58.88 | $66.07 | $93.33 |
CareSource Setting Professional Modifier None Typical Low $75.86 Median $87.10 Typical High $123.03 | Professional | None | $75.86 | $87.10 | $123.03 |
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 $33.88 Median $51.29 Typical High $380.19 | Professional | None | $33.88 | $51.29 | $380.19 |
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 $12.02 Median $33.88 Typical High $52.48 | Professional | None | $12.02 | $33.88 | $52.48 |
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 $21.88 Median $23.99 Typical High $34.67 | Professional | 52 · Reduced service | $21.88 | $23.99 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $9.55 Typical High $13.80 | Professional | 53 · Discontinued | $8.71 | $9.55 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $7.24 Typical High $10.47 | Professional | 55 · Aftercare only | $6.61 | $7.24 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.79 Typical High $6.92 | Professional | 56 · Pre-op care only | $4.37 | $4.79 | $6.92 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | UE · Used equipment | $23.44 | $23.44 | $23.44 |
Where Kentucky sits
The same service costs 2.9 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· 28th of 51
$48.98
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.