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 $186.21 Median $229.09 Typical High $3,801.89 | Facility | None | $186.21 | $229.09 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $213.80 Typical High $316.23 | Professional | None | $186.21 | $213.80 | $316.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $7,244.36 Typical High $8,912.51 | Facility | None | $1,000.00 | $7,244.36 | $8,912.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $125.89 Typical High $199.53 | Professional | None | $107.15 | $125.89 | $199.53 |
CareSource Setting Facility Modifier None Typical Low $234.42 Median $3,981.07 Typical High $5,888.44 | Facility | None | $234.42 | $3,981.07 | $5,888.44 |
CareSource Setting Professional Modifier None Typical Low $323.59 Median $4,073.80 Typical High $7,244.36 | Professional | None | $323.59 | $4,073.80 | $7,244.36 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,548.82 Typical High $1,778.28 | Facility | None | $436.52 | $1,548.82 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
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 $831.76 Median $2,089.30 Typical High $6,760.83 | Facility | None | $831.76 | $2,089.30 | $6,760.83 |
United Setting Professional Modifier None Typical Low $213.80 Median $269.15 Typical High $380.19 | Professional | None | $213.80 | $269.15 | $380.19 |
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 $93.33 Median $107.15 Typical High $114.82 | Professional | 52 · Reduced service | $93.33 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $42.66 Typical High $45.71 | Professional | 53 · Discontinued | $37.15 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $158.49 Typical High $173.78 | Professional | 54 · Surgery only | $141.25 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $31.62 Typical High $34.67 | Professional | 55 · Aftercare only | $28.18 | $31.62 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $21.38 Typical High $22.91 | Professional | 56 · Pre-op care only | $18.62 | $21.38 | $22.91 |
Where Kentucky sits
The same service costs 19.5 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· 44th of 51
$251
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.