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 $38.90 Median $69.18 Typical High $74.13 | Facility | None | $38.90 | $69.18 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $74.13 Typical High $107.15 | Professional | None | $69.18 | $74.13 | $107.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $75.86 Typical High $77.62 | Professional | None | $50.12 | $75.86 | $77.62 |
CareSource Setting Facility Modifier None Typical Low $93.33 Median $104.71 Typical High $144.54 | Facility | None | $93.33 | $104.71 | $144.54 |
CareSource Setting Professional Modifier None Typical Low $114.82 Median $131.83 Typical High $190.55 | Professional | None | $114.82 | $131.83 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $79.43 Typical High $602.56 | Professional | None | $52.48 | $79.43 | $602.56 |
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 $51.29 Typical High $77.62 | Professional | None | $15.14 | $51.29 | $77.62 |
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 $34.67 Median $37.15 Typical High $52.48 | Professional | 52 · Reduced service | $34.67 | $37.15 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $14.79 Typical High $21.38 | Professional | 53 · Discontinued | $13.80 | $14.79 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.96 Typical High $15.85 | Professional | 55 · Aftercare only | $10.47 | $10.96 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.41 Typical High $10.47 | Professional | 56 · Pre-op care only | $6.92 | $7.41 | $10.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | UE · Used equipment | $37.15 | $37.15 | $37.15 |
Where Kentucky sits
The same service costs 4.2 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· 32nd of 51
$75.86
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.