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 $309.03 Median $398.11 Typical High $8,511.38 | Facility | None | $309.03 | $398.11 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $371.54 Typical High $416.87 | Professional | None | $323.59 | $371.54 | $416.87 |
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 $436.52 Median $512.86 Typical High $630.96 | Professional | None | $436.52 | $512.86 | $630.96 |
CareSource Setting Facility Modifier None Typical Low $457.09 Median $8,128.31 Typical High $14,125.38 | Facility | None | $457.09 | $8,128.31 | $14,125.38 |
CareSource Setting Professional Modifier None Typical Low $549.54 Median $7,079.46 Typical High $12,302.69 | Professional | None | $549.54 | $7,079.46 | $12,302.69 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $7,943.28 Typical High $9,120.11 | Facility | None | $758.58 | $7,943.28 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
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 $363.08 Median $512.86 Typical High $630.96 | Professional | None | $363.08 | $512.86 | $630.96 |
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 $151.36 Median $186.21 Typical High $208.93 | Professional | 52 · Reduced service | $151.36 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $74.13 Typical High $83.18 | Professional | 53 · Discontinued | $61.66 | $74.13 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $275.42 Typical High $316.23 | Professional | 54 · Surgery only | $229.09 | $275.42 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $54.95 Typical High $63.10 | Professional | 55 · Aftercare only | $45.71 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $37.15 Typical High $41.69 | Professional | 56 · Pre-op care only | $30.90 | $37.15 | $41.69 |
Where Kentucky sits
The same service costs 16.2 times more in Arkansas than in West Virginia. 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· 47th of 51
$513
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.