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 $7.08 Median $12.88 Typical High $16.98 | Facility | None | $7.08 | $12.88 | $16.98 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $15.85 Typical High $20.89 | Professional | None | $12.88 | $15.85 | $20.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.12 Median $17.38 Typical High $17.38 | Professional | None | $9.12 | $17.38 | $17.38 |
CareSource Setting Facility Modifier None Typical Low $16.98 Median $19.05 Typical High $26.92 | Facility | None | $16.98 | $19.05 | $26.92 |
CareSource Setting Professional Modifier None Typical Low $23.44 Median $30.20 Typical High $43.65 | Professional | None | $23.44 | $30.20 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $9.55 Median $16.98 Typical High $104.71 | Professional | None | $9.55 | $16.98 | $104.71 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $104.71 | Professional | None | $44.67 | $44.67 | $104.71 |
United Setting Professional Modifier None Typical Low $9.55 Median $11.75 Typical High $21.38 | Professional | None | $9.55 | $11.75 | $21.38 |
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 $6.46 Median $7.94 Typical High $10.47 | Professional | 52 · Reduced service | $6.46 | $7.94 | $10.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.57 Median $3.16 Typical High $4.17 | Professional | 53 · Discontinued | $2.57 | $3.16 | $4.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $2.40 Typical High $3.16 | Professional | 55 · Aftercare only | $1.95 | $2.40 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.58 Typical High $2.09 | Professional | 56 · Pre-op care only | $1.29 | $1.58 | $2.09 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | UE · Used equipment | $6.92 | $6.92 | $6.92 |
Where Kentucky sits
The same service costs 3.0 times more in Montana than in New York. 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· 17th of 51
$17.38
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.