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 $43.65 Median $75.86 Typical High $100.00 | Facility | None | $43.65 | $75.86 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $95.50 Typical High $125.89 | Professional | None | $75.86 | $95.50 | $125.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $102.33 Typical High $104.71 | Professional | None | $53.70 | $102.33 | $104.71 |
CareSource Setting Facility Modifier None Typical Low $104.71 Median $117.49 Typical High $162.18 | Facility | None | $104.71 | $117.49 | $162.18 |
CareSource Setting Professional Modifier None Typical Low $141.25 Median $181.97 Typical High $257.04 | Professional | None | $141.25 | $181.97 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $91.20 Typical High $676.08 | Professional | None | $58.88 | $91.20 | $676.08 |
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 $70.79 Typical High $104.71 | Professional | None | $15.14 | $70.79 | $104.71 |
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 $38.02 Median $47.86 Typical High $63.10 | Professional | 52 · Reduced service | $38.02 | $47.86 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $19.05 Typical High $25.12 | Professional | 53 · Discontinued | $15.14 | $19.05 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $14.45 Typical High $19.05 | Professional | 55 · Aftercare only | $11.48 | $14.45 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $9.55 Typical High $12.59 | Professional | 56 · Pre-op care only | $7.59 | $9.55 | $12.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | UE · Used equipment | $40.74 | $40.74 | $40.74 |
Where Kentucky sits
The same service costs 4.0 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· 15th of 51
$102
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.