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 $128.82 Median $331.13 Typical High $3,801.89 | Facility | None | $128.82 | $331.13 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $331.13 Typical High $630.96 | Professional | None | $128.82 | $331.13 | $630.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,698.24 Typical High $2,884.03 | Facility | None | $588.84 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $114.82 Typical High $165.96 | Professional | None | $74.13 | $114.82 | $165.96 |
CareSource Setting Facility Modifier None Typical Low $380.19 Median $6,760.83 Typical High $11,748.98 | Facility | None | $380.19 | $6,760.83 | $11,748.98 |
CareSource Setting Professional Modifier None Typical Low $457.09 Median $5,888.44 Typical High $10,471.29 | Professional | None | $457.09 | $5,888.44 | $10,471.29 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $371.54 Typical High $691.83 | Facility | None | $338.84 | $371.54 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $9,772.37 Median $9,772.37 Typical High $9,772.37 | Professional | None | $9,772.37 | $9,772.37 | $9,772.37 |
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 $323.59 Median $588.84 Typical High $1,621.81 | Facility | None | $323.59 | $588.84 | $1,621.81 |
United Setting Professional Modifier None Typical Low $144.54 Median $204.17 Typical High $281.84 | Professional | None | $144.54 | $204.17 | $281.84 |
4 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 $64.57 Median $165.96 Typical High $316.23 | Professional | 52 · Reduced service | $64.57 | $165.96 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $66.07 Typical High $125.89 | Professional | 53 · Discontinued | $25.70 | $66.07 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $48.98 Typical High $95.50 | Professional | 55 · Aftercare only | $19.50 | $48.98 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $33.11 Typical High $63.10 | Professional | 56 · Pre-op care only | $12.88 | $33.11 | $63.10 |
Where Kentucky sits
The same service costs 24.5 times more in Texas than in Missouri. 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· 48th of 51
$138
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.