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 $794.33 Median $1,479.11 Typical High $2,630.27 | Facility | None | $794.33 | $1,479.11 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $1,862.09 | Professional | None | $1,202.26 | $1,479.11 | $1,862.09 |
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 $147.91 Median $1,174.90 Typical High $1,995.26 | Professional | None | $147.91 | $1,174.90 | $1,995.26 |
CareSource Setting Facility Modifier None Typical Low $1,513.56 Median $25,118.86 Typical High $38,018.94 | Facility | None | $1,513.56 | $25,118.86 | $38,018.94 |
CareSource Setting Professional Modifier None Typical Low $2,041.74 Median $26,302.68 Typical High $46,773.51 | Professional | None | $2,041.74 | $26,302.68 | $46,773.51 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $2,511.89 Typical High $2,818.38 | Facility | None | $794.33 | $2,511.89 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $7,762.47 Median $7,762.47 Typical High $7,762.47 | Professional | None | $7,762.47 | $7,762.47 | $7,762.47 |
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 $2,187.76 Median $2,951.21 Typical High $3,801.89 | Professional | None | $2,187.76 | $2,951.21 | $3,801.89 |
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 $602.56 Median $741.31 Typical High $933.25 | Professional | 52 · Reduced service | $602.56 | $741.31 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $295.12 Typical High $371.54 | Professional | 53 · Discontinued | $239.88 | $295.12 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,096.48 Typical High $1,412.54 | Professional | 54 · Surgery only | $912.01 | $1,096.48 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $218.78 Typical High $281.84 | Professional | 55 · Aftercare only | $181.97 | $218.78 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $147.91 Typical High $186.21 | Professional | 56 · Pre-op care only | $120.23 | $147.91 | $186.21 |
Where Kentucky sits
The same service costs 15.8 times more in Wisconsin 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· 47th of 51
$1,622
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.