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 $851.14 Median $3,388.44 Typical High $9,772.37 | Facility | None | $851.14 | $3,388.44 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $2,754.23 Median $3,388.44 Typical High $7,585.78 | Professional | None | $2,754.23 | $3,388.44 | $7,585.78 |
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 $11,748.98 Median $13,803.84 Typical High $16,595.87 | Professional | None | $11,748.98 | $13,803.84 | $16,595.87 |
CareSource Setting Facility Modifier None Typical Low $3,388.44 Median $57,543.99 Typical High $87,096.36 | Facility | None | $3,388.44 | $57,543.99 | $87,096.36 |
CareSource Setting Professional Modifier None Typical Low $4,677.35 Median $60,255.96 Typical High $104,712.85 | Professional | None | $4,677.35 | $60,255.96 | $104,712.85 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $9,332.54 Typical High $10,232.93 | Facility | None | $794.33 | $9,332.54 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $17,782.79 Median $17,782.79 Typical High $17,782.79 | Professional | None | $17,782.79 | $17,782.79 | $17,782.79 |
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 $1,148.15 Median $3,162.28 Typical High $12,302.69 | Facility | None | $1,148.15 | $3,162.28 | $12,302.69 |
United Setting Professional Modifier None Typical Low $11,481.54 Median $15,488.17 Typical High $19,498.45 | Professional | None | $11,481.54 | $15,488.17 | $19,498.45 |
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 $1,380.38 Median $1,659.59 Typical High $3,801.89 | Professional | 52 · Reduced service | $1,380.38 | $1,659.59 | $3,801.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $676.08 Typical High $1,513.56 | Professional | 53 · Discontinued | $549.54 | $676.08 | $1,513.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,511.89 Typical High $5,754.40 | Professional | 54 · Surgery only | $2,041.74 | $2,511.89 | $5,754.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $501.19 Typical High $1,148.15 | Professional | 55 · Aftercare only | $416.87 | $501.19 | $1,148.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $338.84 Typical High $758.58 | Professional | 56 · Pre-op care only | $275.42 | $338.84 | $758.58 |
Where Kentucky sits
The same service costs 16.6 times more in Indiana than in Nebraska. 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· 8th of 51
$13,804
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.