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 $46.77 Median $77.62 Typical High $109.65 | Facility | None | $46.77 | $77.62 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $100.00 Typical High $141.25 | Professional | None | $77.62 | $100.00 | $141.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $112.20 Typical High $114.82 | Professional | None | $54.95 | $112.20 | $114.82 |
CareSource Setting Facility Modifier None Typical Low $112.20 Median $125.89 Typical High $173.78 | Facility | None | $112.20 | $125.89 | $173.78 |
CareSource Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $281.84 | Professional | None | $151.36 | $199.53 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $100.00 Typical High $691.83 | Professional | None | $63.10 | $100.00 | $691.83 |
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 $77.62 Typical High $112.20 | Professional | None | $15.14 | $77.62 | $112.20 |
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 $38.90 Median $50.12 Typical High $70.79 | Professional | 52 · Reduced service | $38.90 | $50.12 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $19.95 Typical High $28.18 | Professional | 53 · Discontinued | $15.49 | $19.95 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $14.79 Typical High $21.38 | Professional | 55 · Aftercare only | $11.48 | $14.79 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $10.00 Typical High $14.13 | Professional | 56 · Pre-op care only | $7.76 | $10.00 | $14.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | UE · Used equipment | $41.69 | $41.69 | $41.69 |
Where Kentucky sits
The same service costs 2.9 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· 11th of 51
$112
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.