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 $64.57 Median $104.71 Typical High $112.20 | Facility | None | $64.57 | $104.71 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $112.20 Typical High $165.96 | Professional | None | $104.71 | $112.20 | $165.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $114.82 Typical High $117.49 | Professional | None | $75.86 | $114.82 | $117.49 |
CareSource Setting Facility Modifier None Typical Low $151.36 Median $169.82 Typical High $239.88 | Facility | None | $151.36 | $169.82 | $239.88 |
CareSource Setting Professional Modifier None Typical Low $177.83 Median $208.93 Typical High $288.40 | Professional | None | $177.83 | $208.93 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $123.03 Typical High $1,023.29 | Professional | None | $87.10 | $123.03 | $1,023.29 |
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 $79.43 Typical High $125.89 | Professional | None | $15.14 | $79.43 | $125.89 |
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 $52.48 Median $56.23 Typical High $83.18 | Professional | 52 · Reduced service | $52.48 | $56.23 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $22.39 Typical High $33.88 | Professional | 53 · Discontinued | $20.89 | $22.39 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.98 Typical High $25.12 | Professional | 55 · Aftercare only | $15.85 | $16.98 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $11.22 Typical High $16.60 | Professional | 56 · Pre-op care only | $10.47 | $11.22 | $16.60 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | UE · Used equipment | $56.23 | $56.23 | $56.23 |
Where Kentucky sits
The same service costs 5.0 times more in Hawaii than in Florida. 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· 36th of 51
$115
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.