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 $251.19 Median $309.03 Typical High $2,630.27 | Facility | None | $251.19 | $309.03 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $309.03 Typical High $501.19 | Professional | None | $251.19 | $309.03 | $501.19 |
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 $660.69 Median $776.25 Typical High $1,202.26 | Professional | None | $660.69 | $776.25 | $1,202.26 |
CareSource Setting Facility Modifier None Typical Low $354.81 Median $6,309.57 Typical High $10,964.78 | Facility | None | $354.81 | $6,309.57 | $10,964.78 |
CareSource Setting Professional Modifier None Typical Low $426.58 Median $5,495.41 Typical High $9,772.37 | Professional | None | $426.58 | $5,495.41 | $9,772.37 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $831.76 | Facility | None | $588.84 | $588.84 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
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 $691.83 Median $851.14 Typical High $1,348.96 | Professional | None | $691.83 | $851.14 | $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 $125.89 Median $154.88 Typical High $213.80 | Professional | 52 · Reduced service | $125.89 | $154.88 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $61.66 Typical High $85.11 | Professional | 53 · Discontinued | $50.12 | $61.66 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $229.09 Typical High $316.23 | Professional | 54 · Surgery only | $190.55 | $229.09 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $45.71 Typical High $64.57 | Professional | 55 · Aftercare only | $38.02 | $45.71 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $30.90 Typical High $42.66 | Professional | 56 · Pre-op care only | $25.12 | $30.90 | $42.66 |
Where Kentucky sits
The same service costs 7.8 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· 22nd 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.