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 $46.77 Median $46.77 Typical High $50.12 | Facility | None | $46.77 | $46.77 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $50.12 Typical High $74.13 | Professional | None | $46.77 | $50.12 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.11 Median $51.29 Typical High $52.48 | Professional | None | $33.11 | $51.29 | $52.48 |
CareSource Setting Facility Modifier None Typical Low $60.26 Median $67.61 Typical High $93.33 | Facility | None | $60.26 | $67.61 | $93.33 |
CareSource Setting Professional Modifier None Typical Low $77.62 Median $89.13 Typical High $128.82 | Professional | None | $77.62 | $89.13 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $53.70 Typical High $380.19 | Professional | None | $33.88 | $53.70 | $380.19 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $60.26 | Professional | None | $44.67 | $44.67 | $60.26 |
United Setting Professional Modifier None Typical Low $19.05 Median $35.48 Typical High $54.95 | Professional | None | $19.05 | $35.48 | $54.95 |
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 $23.44 Median $25.12 Typical High $37.15 | Professional | 52 · Reduced service | $23.44 | $25.12 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $10.00 Typical High $14.79 | Professional | 53 · Discontinued | $9.33 | $10.00 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $7.59 Typical High $11.22 | Professional | 55 · Aftercare only | $6.92 | $7.59 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.01 Typical High $7.41 | Professional | 56 · Pre-op care only | $4.68 | $5.01 | $7.41 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | UE · Used equipment | $25.12 | $25.12 | $25.12 |
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· 26th of 51
$51.29
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.