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 $26.30 Median $43.65 Typical High $46.77 | Facility | None | $26.30 | $43.65 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $46.77 Typical High $69.18 | Professional | None | $43.65 | $46.77 | $69.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $48.98 Median $52.48 Typical High $54.95 | Professional | None | $48.98 | $52.48 | $54.95 |
CareSource Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
CareSource Setting Professional Modifier None Typical Low $72.44 Median $97.72 Typical High $144.54 | Professional | None | $72.44 | $97.72 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $51.29 Typical High $398.11 | Professional | None | $35.48 | $51.29 | $398.11 |
Molina Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
United Setting Professional Modifier None Typical Low $24.55 Median $36.31 Typical High $60.26 | Professional | None | $24.55 | $36.31 | $60.26 |
6 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 $21.88 Median $23.44 Typical High $34.67 | Professional | 52 · Reduced service | $21.88 | $23.44 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $9.33 Typical High $13.80 | Professional | 53 · Discontinued | $8.71 | $9.33 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $7.08 Typical High $10.47 | Professional | 55 · Aftercare only | $6.61 | $7.08 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.68 Typical High $6.92 | Professional | 56 · Pre-op care only | $4.37 | $4.68 | $6.92 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | RR · Rental | $6.03 | $6.03 | $6.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $27.54 Median $40.74 Typical High $45.71 | Professional | UE · Used equipment | $27.54 | $40.74 | $45.71 |
Where Kentucky sits
The same service costs 2.8 times more in Montana than in Alabama. 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
$48.98
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.