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 $389.05 Median $467.74 Typical High $8,511.38 | Facility | None | $389.05 | $467.74 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $501.19 | Professional | None | $389.05 | $467.74 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $9,549.93 Typical High $11,748.98 | Facility | None | $2,238.72 | $9,549.93 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $758.58 | Professional | None | $501.19 | $588.84 | $758.58 |
CareSource Setting Facility Modifier None Typical Low $478.63 Median $8,128.31 Typical High $12,302.69 | Facility | None | $478.63 | $8,128.31 | $12,302.69 |
CareSource Setting Professional Modifier None Typical Low $660.69 Median $8,511.38 Typical High $14,791.08 | Professional | None | $660.69 | $8,511.38 | $14,791.08 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $19,952.62 Typical High $22,908.68 | Facility | None | $794.33 | $19,952.62 | $22,908.68 |
Cigna Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,884.03 | $2,884.03 | $2,884.03 |
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 $1,096.48 Median $5,128.61 Typical High $29,512.09 | Facility | None | $1,096.48 | $5,128.61 | $29,512.09 |
United Setting Professional Modifier None Typical Low $575.44 Median $758.58 Typical High $977.24 | Professional | None | $575.44 | $758.58 | $977.24 |
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 $194.98 Median $234.42 Typical High $251.19 | Professional | 52 · Reduced service | $194.98 | $234.42 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $93.33 Typical High $100.00 | Professional | 53 · Discontinued | $77.62 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $354.81 Typical High $371.54 | Professional | 54 · Surgery only | $288.40 | $354.81 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $70.79 Typical High $74.13 | Professional | 55 · Aftercare only | $57.54 | $70.79 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $46.77 Typical High $50.12 | Professional | 56 · Pre-op care only | $38.90 | $46.77 | $50.12 |
Where Kentucky sits
The same service costs 29.5 times more in Louisiana than in Maine. 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
$646
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.