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 $891.25 Median $1,348.96 Typical High $8,511.38 | Facility | None | $891.25 | $1,348.96 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $1,513.56 | Professional | None | $1,122.02 | $1,348.96 | $1,513.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,148.15 Median $7,943.28 Typical High $10,000.00 | Facility | None | $1,148.15 | $7,943.28 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $3,090.30 Typical High $3,981.07 | Professional | None | $660.69 | $3,090.30 | $3,981.07 |
CareSource Setting Facility Modifier None Typical Low $1,380.38 Median $23,442.29 Typical High $35,481.34 | Facility | None | $1,380.38 | $23,442.29 | $35,481.34 |
CareSource Setting Professional Modifier None Typical Low $1,905.46 Median $24,547.09 Typical High $42,657.95 | Professional | None | $1,905.46 | $24,547.09 | $42,657.95 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $7,943.28 Typical High $8,912.51 | Facility | None | $794.33 | $7,943.28 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $6,760.83 Median $6,760.83 Typical High $6,760.83 | Professional | None | $6,760.83 | $6,760.83 | $6,760.83 |
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 $977.24 Median $1,862.09 Typical High $7,943.28 | Facility | None | $977.24 | $1,862.09 | $7,943.28 |
United Setting Professional Modifier None Typical Low $1,621.81 Median $2,041.74 Typical High $2,754.23 | Professional | None | $1,621.81 | $2,041.74 | $2,754.23 |
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 $562.34 Median $676.08 Typical High $724.44 | Professional | 52 · Reduced service | $562.34 | $676.08 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $275.42 Typical High $288.40 | Professional | 53 · Discontinued | $223.87 | $275.42 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,023.29 Typical High $1,096.48 | Professional | 54 · Surgery only | $831.76 | $1,023.29 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $204.17 Typical High $218.78 | Professional | 55 · Aftercare only | $165.96 | $204.17 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $134.90 Typical High $144.54 | Professional | 56 · Pre-op care only | $112.20 | $134.90 | $144.54 |
Where Kentucky sits
The same service costs 4.9 times more in Alaska than in Indiana. 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· 44th of 51
$2,042
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.