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 $12.59 Median $21.88 Typical High $22.39 | Facility | None | $12.59 | $21.88 | $22.39 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $22.39 Typical High $33.11 | Professional | None | $21.88 | $22.39 | $33.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.22 Median $22.39 Typical High $22.91 | Professional | None | $16.22 | $22.39 | $22.91 |
CareSource Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
CareSource Setting Professional Modifier None Typical Low $33.88 Median $46.77 Typical High $69.18 | Professional | None | $33.88 | $46.77 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $16.60 Median $23.99 Typical High $194.98 | Professional | None | $16.60 | $23.99 | $194.98 |
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 $12.30 Median $16.98 Typical High $28.18 | Professional | None | $12.30 | $16.98 | $28.18 |
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 $10.96 Median $11.22 Typical High $16.60 | Professional | 52 · Reduced service | $10.96 | $11.22 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.47 Typical High $6.61 | Professional | 53 · Discontinued | $4.37 | $4.47 | $6.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.39 Typical High $5.01 | Professional | 55 · Aftercare only | $3.31 | $3.39 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.24 Typical High $3.31 | Professional | 56 · Pre-op care only | $2.19 | $2.24 | $3.31 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | UE · Used equipment | $12.02 | $12.02 | $12.02 |
Where Kentucky sits
The same service costs 5.9 times more in Hawaii than in Utah. 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· 38th of 51
$22.39
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.