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 $19.50 Median $33.88 Typical High $36.31 | Facility | None | $19.50 | $33.88 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $36.31 Typical High $53.70 | Professional | None | $33.88 | $36.31 | $53.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.70 Median $35.48 Typical High $35.48 | Professional | None | $25.70 | $35.48 | $35.48 |
CareSource Setting Facility Modifier None Typical Low $45.71 Median $51.29 Typical High $72.44 | Facility | None | $45.71 | $51.29 | $72.44 |
CareSource Setting Professional Modifier None Typical Low $53.70 Median $63.10 Typical High $89.13 | Professional | None | $53.70 | $63.10 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $37.15 Typical High $288.40 | Professional | None | $26.30 | $37.15 | $288.40 |
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 $23.99 Typical High $43.65 | Professional | None | $12.02 | $23.99 | $43.65 |
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 $16.98 Median $17.78 Typical High $26.92 | Professional | 52 · Reduced service | $16.98 | $17.78 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $7.24 Typical High $10.72 | Professional | 53 · Discontinued | $6.92 | $7.24 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.37 Typical High $7.94 | Professional | 55 · Aftercare only | $5.13 | $5.37 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.63 Typical High $5.37 | Professional | 56 · Pre-op care only | $3.39 | $3.63 | $5.37 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | UE · Used equipment | $19.50 | $19.50 | $19.50 |
Where Kentucky sits
The same service costs 3.9 times more in Montana than in Alaska. 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· 33rd of 51
$35.48
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.