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 $263.03 Median $316.23 Typical High $5,248.07 | Facility | None | $263.03 | $316.23 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $316.23 Typical High $416.87 | Professional | None | $263.03 | $316.23 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $776.25 Median $3,981.07 Typical High $5,011.87 | Facility | None | $776.25 | $3,981.07 | $5,011.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $371.54 Typical High $467.74 | Professional | None | $309.03 | $371.54 | $467.74 |
CareSource Setting Facility Modifier None Typical Low $363.08 Median $6,456.54 Typical High $11,481.54 | Facility | None | $363.08 | $6,456.54 | $11,481.54 |
CareSource Setting Professional Modifier None Typical Low $446.68 Median $5,754.40 Typical High $10,000.00 | Professional | None | $446.68 | $5,754.40 | $10,000.00 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,230.27 Typical High $1,380.38 | Facility | None | $616.60 | $1,230.27 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
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 $457.09 Median $794.33 Typical High $2,454.71 | Facility | None | $457.09 | $794.33 | $2,454.71 |
United Setting Professional Modifier None Typical Low $512.86 Median $676.08 Typical High $870.96 | Professional | None | $512.86 | $676.08 | $870.96 |
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 $131.83 Median $158.49 Typical High $208.93 | Professional | 52 · Reduced service | $131.83 | $158.49 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $63.10 Typical High $83.18 | Professional | 53 · Discontinued | $52.48 | $63.10 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $239.88 Typical High $309.03 | Professional | 54 · Surgery only | $194.98 | $239.88 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $47.86 Typical High $61.66 | Professional | 55 · Aftercare only | $38.90 | $47.86 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $31.62 Typical High $41.69 | Professional | 56 · Pre-op care only | $26.30 | $31.62 | $41.69 |
Where Kentucky sits
The same service costs 8.1 times more in Texas 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
$417
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.