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 $1,071.52 Median $1,318.26 Typical High $1,380.38 | Facility | None | $1,071.52 | $1,318.26 | $1,380.38 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $1,380.38 | Professional | None | $1,071.52 | $1,318.26 | $1,380.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,584.89 Median $4,786.30 Typical High $5,888.44 | Facility | None | $1,584.89 | $4,786.30 | $5,888.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,318.26 Typical High $1,584.89 | Professional | None | $1,122.02 | $1,318.26 | $1,584.89 |
CareSource Setting Facility Modifier None Typical Low $1,513.56 Median $26,915.35 Typical High $46,773.51 | Facility | None | $1,513.56 | $26,915.35 | $46,773.51 |
CareSource Setting Professional Modifier None Typical Low $1,819.70 Median $23,442.29 Typical High $41,686.94 | Professional | None | $1,819.70 | $23,442.29 | $41,686.94 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $794.33 Typical High $2,511.89 | Facility | None | $467.74 | $794.33 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $6,918.31 | Professional | None | $6,918.31 | $6,918.31 | $6,918.31 |
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 $354.81 Median $912.01 Typical High $8,317.64 | Facility | None | $354.81 | $912.01 | $8,317.64 |
United Setting Professional Modifier None Typical Low $1,659.59 Median $2,187.76 Typical High $2,818.38 | Professional | None | $1,659.59 | $2,187.76 | $2,818.38 |
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 $537.03 Median $660.69 Typical High $691.83 | Professional | 52 · Reduced service | $537.03 | $660.69 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $263.03 Typical High $275.42 | Professional | 53 · Discontinued | $213.80 | $263.03 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $977.24 Typical High $1,047.13 | Professional | 54 · Surgery only | $812.83 | $977.24 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $194.98 Typical High $208.93 | Professional | 55 · Aftercare only | $162.18 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $131.83 Typical High $138.04 | Professional | 56 · Pre-op care only | $107.15 | $131.83 | $138.04 |
Where Kentucky sits
The same service costs 6.8 times more in Alaska than in Arkansas. 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· 46th of 51
$1,318
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.