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 $17.78 Median $21.88 Typical High $75.86 | Facility | None | $17.78 | $21.88 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $15.85 Median $17.78 Typical High $75.86 | Professional | None | $15.85 | $17.78 | $75.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,019.95 Median $3,388.44 Typical High $3,801.89 | Facility | None | $3,019.95 | $3,388.44 | $3,801.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $154.88 Median $213.80 Typical High $302.00 | Professional | None | $154.88 | $213.80 | $302.00 |
CareSource Setting Facility Modifier None Typical Low $21.88 Median $371.54 Typical High $562.34 | Facility | None | $21.88 | $371.54 | $562.34 |
CareSource Setting Professional Modifier None Typical Low $25.12 Median $389.05 Typical High $676.08 | Professional | None | $25.12 | $389.05 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
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 Facility Modifier None Typical Low $50.12 Median $416.87 Typical High $1,949.84 | Facility | None | $50.12 | $416.87 | $1,949.84 |
United Setting Professional Modifier None Typical Low $15.14 Median $17.78 Typical High $32.36 | Professional | None | $15.14 | $17.78 | $32.36 |
4 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 $7.94 Median $8.91 Typical High $37.15 | Professional | 52 · Reduced service | $7.94 | $8.91 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $3.55 Typical High $15.14 | Professional | 53 · Discontinued | $3.16 | $3.55 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $2.63 Typical High $11.22 | Professional | 55 · Aftercare only | $2.34 | $2.63 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $1.78 Typical High $7.59 | Professional | 56 · Pre-op care only | $1.58 | $1.78 | $7.59 |
Where Kentucky sits
The same service costs 19.1 times more in Indiana than in Delaware. 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· 4th of 51
$186
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.