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 $29.51 Median $50.12 Typical High $56.23 | Facility | None | $29.51 | $50.12 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $56.23 Typical High $79.43 | Professional | None | $50.12 | $56.23 | $79.43 |
Anthem BCBS Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $36.31 Median $57.54 Typical High $58.88 | Professional | None | $36.31 | $57.54 | $58.88 |
CareSource Setting Facility Modifier None Typical Low $69.18 Median $77.62 Typical High $109.65 | Facility | None | $69.18 | $77.62 | $109.65 |
CareSource Setting Professional Modifier None Typical Low $87.10 Median $102.33 Typical High $144.54 | Professional | None | $87.10 | $102.33 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $60.26 Typical High $446.68 | Professional | None | $39.81 | $60.26 | $446.68 |
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 $39.81 Typical High $64.57 | Professional | None | $15.14 | $39.81 | $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 $25.12 Median $28.18 Typical High $39.81 | Professional | 52 · Reduced service | $25.12 | $28.18 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $11.22 Typical High $15.85 | Professional | 53 · Discontinued | $10.00 | $11.22 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $8.51 Typical High $12.02 | Professional | 55 · Aftercare only | $7.59 | $8.51 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.62 Typical High $7.94 | Professional | 56 · Pre-op care only | $5.01 | $5.62 | $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 2.7 times more in Hawaii 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· 28th of 51
$57.54
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.