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 $239.88 Median $295.12 Typical High $794.33 | Facility | None | $239.88 | $295.12 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $295.12 Typical High $316.23 | Professional | None | $239.88 | $295.12 | $316.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $812.83 Median $5,888.44 Typical High $7,244.36 | Facility | None | $812.83 | $5,888.44 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $398.11 | Professional | None | $288.40 | $338.84 | $398.11 |
CareSource Setting Facility Modifier None Typical Low $302.00 Median $5,011.87 Typical High $7,585.78 | Facility | None | $302.00 | $5,011.87 | $7,585.78 |
CareSource Setting Professional Modifier None Typical Low $407.38 Median $5,248.07 Typical High $9,332.54 | Professional | None | $407.38 | $5,248.07 | $9,332.54 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $562.34 Typical High $562.34 | Facility | None | $467.74 | $562.34 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
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 $316.23 Median $467.74 Typical High $602.56 | Professional | None | $316.23 | $467.74 | $602.56 |
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 $120.23 Median $147.91 Typical High $154.88 | Professional | 52 · Reduced service | $120.23 | $147.91 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $58.88 Typical High $63.10 | Professional | 53 · Discontinued | $47.86 | $58.88 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $218.78 Typical High $234.42 | Professional | 54 · Surgery only | $181.97 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $43.65 Typical High $46.77 | Professional | 55 · Aftercare only | $36.31 | $43.65 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $29.51 Typical High $31.62 | Professional | 56 · Pre-op care only | $23.99 | $29.51 | $31.62 |
Where Kentucky sits
The same service costs 6.3 times more in Texas than in Pennsylvania. 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
$339
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.