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 $28.18 Median $48.98 Typical High $52.48 | Facility | None | $28.18 | $48.98 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $52.48 Typical High $77.62 | Professional | None | $48.98 | $52.48 | $77.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.02 Median $50.12 Typical High $51.29 | Professional | None | $38.02 | $50.12 | $51.29 |
CareSource Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
CareSource Setting Professional Modifier None Typical Low $77.62 Median $104.71 Typical High $154.88 | Professional | None | $77.62 | $104.71 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $53.70 Typical High $436.52 | Professional | None | $38.02 | $53.70 | $436.52 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
United Setting Professional Modifier None Typical Low $29.51 Median $38.02 Typical High $63.10 | Professional | None | $29.51 | $38.02 | $63.10 |
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 $24.55 Median $26.30 Typical High $38.90 | Professional | 52 · Reduced service | $24.55 | $26.30 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $10.47 Typical High $15.49 | Professional | 53 · Discontinued | $9.77 | $10.47 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.94 Typical High $11.48 | Professional | 55 · Aftercare only | $7.41 | $7.94 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $5.25 Typical High $7.76 | Professional | 56 · Pre-op care only | $4.90 | $5.25 | $7.76 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | UE · Used equipment | $28.18 | $28.18 | $28.18 |
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· 37th of 51
$50.12
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.