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 $4.68 Median $7.41 Typical High $9.55 | Facility | None | $4.68 | $7.41 | $9.55 |
Aetna Setting Professional Modifier None Typical Low $7.41 Median $9.33 Typical High $12.30 | Professional | None | $7.41 | $9.33 | $12.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Facility | None | $15.14 | $15.14 | $15.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.25 Median $6.76 Typical High $9.77 | Professional | None | $5.25 | $6.76 | $9.77 |
CareSource Setting Facility Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Facility | None | $14.79 | $14.79 | $14.79 |
CareSource Setting Professional Modifier None Typical Low $14.79 Median $19.95 Typical High $29.51 | Professional | None | $14.79 | $19.95 | $29.51 |
Cigna Setting Facility Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Facility | None | $20.42 | $20.42 | $20.42 |
Cigna Setting Professional Modifier None Typical Low $6.03 Median $9.55 Typical High $67.61 | Professional | None | $6.03 | $9.55 | $67.61 |
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 $3.98 Median $6.76 Typical High $11.48 | Professional | None | $3.98 | $6.76 | $11.48 |
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 $3.72 Median $4.68 Typical High $6.17 | Professional | 52 · Reduced service | $3.72 | $4.68 | $6.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.48 Median $1.86 Typical High $2.45 | Professional | 53 · Discontinued | $1.48 | $1.86 | $2.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.12 Median $1.41 Typical High $1.86 | Professional | 55 · Aftercare only | $1.12 | $1.41 | $1.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.74 Median $0.93 Typical High $1.23 | Professional | 56 · Pre-op care only | $0.74 | $0.93 | $1.23 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.98 Median $5.25 Typical High $5.25 | Professional | UE · Used equipment | $3.98 | $5.25 | $5.25 |
Where Kentucky sits
The same service costs 2.7 times more in Montana 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· 37th of 51
$7.41
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.