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 $50.12 Typical High $53.70 | Facility | None | $28.18 | $50.12 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $53.70 Typical High $77.62 | Professional | None | $50.12 | $53.70 | $77.62 |
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 $35.48 Median $54.95 Typical High $56.23 | Professional | None | $35.48 | $54.95 | $56.23 |
CareSource Setting Facility Modifier None Typical Low $66.07 Median $74.13 Typical High $104.71 | Facility | None | $66.07 | $74.13 | $104.71 |
CareSource Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $138.04 | Professional | None | $83.18 | $97.72 | $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 $57.54 Typical High $426.58 | Professional | None | $38.02 | $57.54 | $426.58 |
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 $38.02 Typical High $64.57 | Professional | None | $15.14 | $38.02 | $64.57 |
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 $24.55 Median $26.92 Typical High $38.90 | Professional | 52 · Reduced service | $24.55 | $26.92 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.72 Typical High $15.49 | Professional | 53 · Discontinued | $10.00 | $10.72 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $8.13 Typical High $11.48 | Professional | 55 · Aftercare only | $7.41 | $8.13 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.37 Typical High $7.76 | Professional | 56 · Pre-op care only | $5.01 | $5.37 | $7.76 |
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 2.7 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· 32nd 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.