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 $33.88 Median $58.88 Typical High $63.10 | Facility | None | $33.88 | $58.88 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $63.10 Typical High $93.33 | Professional | None | $58.88 | $63.10 | $93.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $45.71 Median $61.66 Typical High $61.66 | Professional | None | $45.71 | $61.66 | $61.66 |
CareSource Setting Facility Modifier None Typical Low $79.43 Median $89.13 Typical High $125.89 | Facility | None | $79.43 | $89.13 | $125.89 |
CareSource Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $151.36 | Professional | None | $93.33 | $109.65 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $64.57 Typical High $512.86 | Professional | None | $45.71 | $64.57 | $512.86 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $56.23 | Professional | None | $44.67 | $44.67 | $56.23 |
United Setting Professional Modifier None Typical Low $15.14 Median $41.69 Typical High $70.79 | Professional | None | $15.14 | $41.69 | $70.79 |
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 $29.51 Median $31.62 Typical High $46.77 | Professional | 52 · Reduced service | $29.51 | $31.62 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $12.59 Typical High $18.62 | Professional | 53 · Discontinued | $11.75 | $12.59 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.55 Typical High $13.80 | Professional | 55 · Aftercare only | $8.91 | $9.55 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.31 Typical High $9.33 | Professional | 56 · Pre-op care only | $5.89 | $6.31 | $9.33 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | UE · Used equipment | $33.88 | $33.88 | $33.88 |
Where Kentucky sits
The same service costs 2.9 times more in Hawaii than in New York. 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· 36th of 51
$61.66
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.