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 $562.34 Median $1,023.29 Typical High $1,096.48 | Facility | None | $562.34 | $1,023.29 | $1,096.48 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $1,621.81 | Professional | None | $1,023.29 | $1,096.48 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,230.27 Typical High $2,089.30 | Professional | None | $1,148.15 | $1,230.27 | $2,089.30 |
CareSource Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
CareSource Setting Professional Modifier None Typical Low $1,737.80 Median $2,344.23 Typical High $3,467.37 | Professional | None | $1,737.80 | $2,344.23 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,148.15 Typical High $8,317.64 | Professional | None | $758.58 | $1,148.15 | $8,317.64 |
Molina Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
United Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $1,412.54 | Professional | None | $575.44 | $776.25 | $1,412.54 |
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 $512.86 Median $549.54 Typical High $812.83 | Professional | 52 · Reduced service | $512.86 | $549.54 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $218.78 Typical High $323.59 | Professional | 53 · Discontinued | $204.17 | $218.78 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $165.96 Typical High $245.47 | Professional | 55 · Aftercare only | $154.88 | $165.96 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $109.65 Typical High $162.18 | Professional | 56 · Pre-op care only | $102.33 | $109.65 | $162.18 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | RR · Rental | $229.09 | $229.09 | $229.09 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $645.65 Median $1,479.11 Typical High $1,737.80 | Professional | UE · Used equipment | $645.65 | $1,479.11 | $1,737.80 |
Where Kentucky sits
The same service costs 2.7 times more in Montana than in New Jersey. 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· 27th of 51
$1,175
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.