How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $275.42 Median $338.84 Typical High $8,511.38 | Facility | None | $275.42 | $338.84 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $338.84 Typical High $354.81 | Professional | None | $275.42 | $338.84 | $354.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $9,549.93 Typical High $11,748.98 | Facility | None | $2,238.72 | $9,549.93 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $331.13 Typical High $426.58 | Professional | None | $281.84 | $331.13 | $426.58 |
CareSource Setting Facility Modifier None Typical Low $338.84 Median $5,754.40 Typical High $8,709.64 | Facility | None | $338.84 | $5,754.40 | $8,709.64 |
CareSource Setting Professional Modifier None Typical Low $467.74 Median $6,025.60 Typical High $10,471.29 | Professional | None | $467.74 | $6,025.60 | $10,471.29 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $20,892.96 Typical High $23,442.29 | Facility | None | $588.84 | $20,892.96 | $23,442.29 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
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 $1,096.48 Median $5,128.61 Typical High $29,512.09 | Facility | None | $1,096.48 | $5,128.61 | $29,512.09 |
United Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $707.95 | Professional | None | $416.87 | $562.34 | $707.95 |
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 $138.04 Median $165.96 Typical High $177.83 | Professional | 52 · Reduced service | $138.04 | $165.96 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $67.61 Typical High $70.79 | Professional | 53 · Discontinued | $54.95 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $251.19 Typical High $269.15 | Professional | 54 · Surgery only | $204.17 | $251.19 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $50.12 Typical High $53.70 | Professional | 55 · Aftercare only | $41.69 | $50.12 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $33.88 Typical High $35.48 | Professional | 56 · Pre-op care only | $27.54 | $33.88 | $35.48 |
Where Kentucky sits
The same service costs 63.1 times more in Arkansas 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· 50th of 51
$380
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.