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 $28.18 Median $51.29 Typical High $53.70 | Facility | None | $28.18 | $51.29 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $53.70 Typical High $81.28 | Professional | None | $51.29 | $53.70 | $81.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $36.31 Median $54.95 Typical High $56.23 | Professional | None | $36.31 | $54.95 | $56.23 |
CareSource Setting Facility Modifier None Typical Low $67.61 Median $75.86 Typical High $104.71 | Facility | None | $67.61 | $75.86 | $104.71 |
CareSource Setting Professional Modifier None Typical Low $83.18 Median $95.50 Typical High $138.04 | Professional | None | $83.18 | $95.50 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $58.88 Typical High $426.58 | Professional | None | $38.02 | $58.88 | $426.58 |
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 $38.02 Typical High $57.54 | Professional | None | $12.02 | $38.02 | $57.54 |
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 $25.12 Median $26.92 Typical High $39.81 | Professional | 52 · Reduced service | $25.12 | $26.92 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.72 Typical High $16.22 | Professional | 53 · Discontinued | $10.23 | $10.72 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.94 Typical High $12.02 | Professional | 55 · Aftercare only | $7.59 | $7.94 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.37 Typical High $7.94 | Professional | 56 · Pre-op care only | $5.13 | $5.37 | $7.94 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | UE · Used equipment | $26.92 | $26.92 | $26.92 |
Where Kentucky sits
The same service costs 2.6 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· 30th of 51
$54.95
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.