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 $186.21 Median $223.87 Typical High $8,511.38 | Facility | None | $186.21 | $223.87 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $223.87 Typical High $239.88 | Professional | None | $186.21 | $223.87 | $239.88 |
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 $213.80 Median $251.19 Typical High $309.03 | Professional | None | $213.80 | $251.19 | $309.03 |
CareSource Setting Facility Modifier None Typical Low $229.09 Median $3,890.45 Typical High $5,888.44 | Facility | None | $229.09 | $3,890.45 | $5,888.44 |
CareSource Setting Professional Modifier None Typical Low $316.23 Median $4,073.80 Typical High $7,079.46 | Professional | None | $316.23 | $4,073.80 | $7,079.46 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $2,187.76 Typical High $2,511.89 | Facility | None | $436.52 | $2,187.76 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
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 $741.31 Median $1,479.11 Typical High $5,128.61 | Facility | None | $741.31 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $457.09 | Professional | None | $269.15 | $354.81 | $457.09 |
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 $93.33 Median $112.20 Typical High $120.23 | Professional | 52 · Reduced service | $93.33 | $112.20 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $44.67 Typical High $47.86 | Professional | 53 · Discontinued | $37.15 | $44.67 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $169.82 Typical High $177.83 | Professional | 54 · Surgery only | $138.04 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $33.88 Typical High $36.31 | Professional | 55 · Aftercare only | $27.54 | $33.88 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $22.39 Typical High $23.99 | Professional | 56 · Pre-op care only | $18.62 | $22.39 | $23.99 |
Where Kentucky sits
The same service costs 10.7 times more in Colorado 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
$282
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.