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 $26.30 Median $43.65 Typical High $48.98 | Facility | None | $26.30 | $43.65 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $48.98 Typical High $69.18 | Professional | None | $43.65 | $48.98 | $69.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $50.12 Typical High $51.29 | Professional | None | $30.90 | $50.12 | $51.29 |
CareSource Setting Facility Modifier None Typical Low $61.66 Median $69.18 Typical High $97.72 | Facility | None | $61.66 | $69.18 | $97.72 |
CareSource Setting Professional Modifier None Typical Low $75.86 Median $87.10 Typical High $125.89 | Professional | None | $75.86 | $87.10 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $53.70 Typical High $398.11 | Professional | None | $35.48 | $53.70 | $398.11 |
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 $21.38 Median $24.55 Typical High $33.88 | Professional | 52 · Reduced service | $21.38 | $24.55 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $9.77 Typical High $13.80 | Professional | 53 · Discontinued | $8.71 | $9.77 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $7.24 Typical High $10.23 | Professional | 55 · Aftercare only | $6.46 | $7.24 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.90 Typical High $6.92 | Professional | 56 · Pre-op care only | $4.37 | $4.90 | $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 Hawaii 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· 30th of 51
$50.12
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.