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 $7.24 Median $12.02 Typical High $14.13 | Facility | None | $7.24 | $12.02 | $14.13 |
Aetna Setting Professional Modifier None Typical Low $12.02 Median $14.13 Typical High $19.05 | Professional | None | $12.02 | $14.13 | $19.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Facility | None | $22.39 | $22.39 | $22.39 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.71 Median $14.45 Typical High $14.79 | Professional | None | $8.71 | $14.45 | $14.79 |
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 $21.88 Median $25.12 Typical High $36.31 | Professional | None | $21.88 | $25.12 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $14.79 Typical High $107.15 | Professional | None | $9.77 | $14.79 | $107.15 |
Molina Setting Professional Modifier None Typical Low $19.50 Median $44.67 Typical High $44.67 | Professional | None | $19.50 | $44.67 | $44.67 |
United Setting Professional Modifier None Typical Low $6.03 Median $10.00 Typical High $15.14 | Professional | None | $6.03 | $10.00 | $15.14 |
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 $6.03 Median $7.08 Typical High $9.55 | Professional | 52 · Reduced service | $6.03 | $7.08 | $9.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.40 Median $2.82 Typical High $3.80 | Professional | 53 · Discontinued | $2.40 | $2.82 | $3.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $2.14 Typical High $2.88 | Professional | 55 · Aftercare only | $1.82 | $2.14 | $2.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.20 Median $1.41 Typical High $1.91 | Professional | 56 · Pre-op care only | $1.20 | $1.41 | $1.91 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | UE · Used equipment | $6.46 | $6.46 | $6.46 |
Where Kentucky sits
The same service costs 3.2 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· 30th of 51
$14.45
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.