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 $588.84 Median $691.83 Typical High $2,630.27 | Facility | None | $588.84 | $691.83 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $758.58 | Professional | None | $588.84 | $724.44 | $758.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,311.31 Typical High $9,120.11 | Facility | None | $1,047.13 | $3,311.31 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $831.76 | Professional | None | $630.96 | $741.31 | $831.76 |
CareSource Setting Facility Modifier None Typical Low $831.76 Median $14,791.08 Typical High $26,302.68 | Facility | None | $831.76 | $14,791.08 | $26,302.68 |
CareSource Setting Professional Modifier None Typical Low $1,023.29 Median $12,882.50 Typical High $22,908.68 | Professional | None | $1,023.29 | $12,882.50 | $22,908.68 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $4,265.80 Typical High $4,786.30 | Facility | None | $794.33 | $4,265.80 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Professional | None | $3,801.89 | $3,801.89 | $3,801.89 |
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 $616.60 Median $741.31 Typical High $1,348.96 | Professional | None | $616.60 | $741.31 | $1,348.96 |
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 $295.12 Median $363.08 Typical High $380.19 | Professional | 52 · Reduced service | $295.12 | $363.08 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $144.54 Typical High $154.88 | Professional | 53 · Discontinued | $117.49 | $144.54 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $537.03 Typical High $575.44 | Professional | 54 · Surgery only | $446.68 | $537.03 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $109.65 Typical High $114.82 | Professional | 55 · Aftercare only | $89.13 | $109.65 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $72.44 Typical High $75.86 | Professional | 56 · Pre-op care only | $58.88 | $72.44 | $75.86 |
Where Kentucky sits
The same service costs 5.1 times more in Texas 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· 49th of 51
$776
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.