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 $52.48 Median $85.11 Typical High $120.23 | Facility | None | $52.48 | $85.11 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $107.15 Typical High $151.36 | Professional | None | $85.11 | $107.15 | $151.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $77.62 Typical High $123.03 | Professional | None | $60.26 | $77.62 | $123.03 |
CareSource Setting Facility Modifier None Typical Low $123.03 Median $138.04 Typical High $190.55 | Facility | None | $123.03 | $138.04 | $190.55 |
CareSource Setting Professional Modifier None Typical Low $165.96 Median $218.78 Typical High $309.03 | Professional | None | $165.96 | $218.78 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $107.15 Typical High $794.33 | Professional | None | $69.18 | $107.15 | $794.33 |
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 $85.11 Typical High $123.03 | Professional | None | $15.14 | $85.11 | $123.03 |
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 $42.66 Median $53.70 Typical High $75.86 | Professional | 52 · Reduced service | $42.66 | $53.70 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $21.38 Typical High $30.20 | Professional | 53 · Discontinued | $16.98 | $21.38 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $16.22 Typical High $22.39 | Professional | 55 · Aftercare only | $12.59 | $16.22 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $10.72 Typical High $15.14 | Professional | 56 · Pre-op care only | $8.51 | $10.72 | $15.14 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | UE · Used equipment | $45.71 | $45.71 | $45.71 |
Where Kentucky sits
The same service costs 3.0 times more in Hawaii than in Indiana. 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· 41st of 51
$85.11
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.