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 $8.51 Median $14.13 Typical High $15.85 | Facility | None | $8.51 | $14.13 | $15.85 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $15.85 Typical High $22.39 | Professional | None | $14.13 | $15.85 | $22.39 |
Anthem BCBS Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.00 Median $16.22 Typical High $16.60 | Professional | None | $10.00 | $16.22 | $16.60 |
CareSource Setting Facility Modifier None Typical Low $20.42 Median $22.91 Typical High $31.62 | Facility | None | $20.42 | $22.91 | $31.62 |
CareSource Setting Professional Modifier None Typical Low $24.55 Median $28.84 Typical High $40.74 | Professional | None | $24.55 | $28.84 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $17.38 Typical High $134.90 | Professional | None | $11.48 | $17.38 | $134.90 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $44.67 Typical High $44.67 | Professional | None | $21.88 | $44.67 | $44.67 |
United Setting Professional Modifier None Typical Low $8.32 Median $11.48 Typical High $20.42 | Professional | None | $8.32 | $11.48 | $20.42 |
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 $7.08 Median $7.94 Typical High $11.22 | Professional | 52 · Reduced service | $7.08 | $7.94 | $11.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $3.16 Typical High $4.47 | Professional | 53 · Discontinued | $2.82 | $3.16 | $4.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.09 Median $2.40 Typical High $3.39 | Professional | 55 · Aftercare only | $2.09 | $2.40 | $3.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $1.58 Typical High $2.24 | Professional | 56 · Pre-op care only | $1.41 | $1.58 | $2.24 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | UE · Used equipment | $7.59 | $7.59 | $7.59 |
Where Kentucky sits
The same service costs 4.6 times more in Hawaii than in Ohio. 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· 34th of 51
$16.22
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.