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 $56.23 Typical High $69.18 | Facility | None | $33.88 | $56.23 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $69.18 Typical High $89.13 | Professional | None | $56.23 | $69.18 | $89.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $70.79 Typical High $72.44 | Professional | None | $39.81 | $70.79 | $72.44 |
CareSource Setting Facility Modifier None Typical Low $81.28 Median $91.20 Typical High $125.89 | Facility | None | $81.28 | $91.20 | $125.89 |
CareSource Setting Professional Modifier None Typical Low $107.15 Median $123.03 Typical High $177.83 | Professional | None | $107.15 | $123.03 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $69.18 Typical High $512.86 | Professional | None | $45.71 | $69.18 | $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 $48.98 Typical High $70.79 | Professional | None | $15.14 | $48.98 | $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 $28.18 Median $34.67 Typical High $44.67 | Professional | 52 · Reduced service | $28.18 | $34.67 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $13.80 Typical High $17.78 | Professional | 53 · Discontinued | $11.22 | $13.80 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $10.47 Typical High $13.49 | Professional | 55 · Aftercare only | $8.32 | $10.47 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.92 Typical High $8.91 | Professional | 56 · Pre-op care only | $5.62 | $6.92 | $8.91 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | UE · Used equipment | $30.20 | $30.20 | $30.20 |
Where Kentucky sits
The same service costs 2.3 times more in Hawaii than in Utah. 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· 26th of 51
$70.79
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.