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 $275.42 Median $338.84 Typical High $7,943.28 | Facility | None | $275.42 | $338.84 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $338.84 Typical High $758.58 | Professional | None | $275.42 | $338.84 | $758.58 |
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 $295.12 Median $346.74 Typical High $407.38 | Professional | None | $295.12 | $346.74 | $407.38 |
CareSource Setting Facility Modifier None Typical Low $338.84 Median $5,754.40 Typical High $8,709.64 | Facility | None | $338.84 | $5,754.40 | $8,709.64 |
CareSource Setting Professional Modifier None Typical Low $467.74 Median $6,025.60 Typical High $10,471.29 | Professional | None | $467.74 | $6,025.60 | $10,471.29 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $21,877.62 Typical High $25,118.86 | Facility | None | $602.56 | $21,877.62 | $25,118.86 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
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 $1,096.48 Median $5,128.61 Typical High $29,512.09 | Facility | None | $1,096.48 | $5,128.61 | $29,512.09 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,258.93 Typical High $1,659.59 | Professional | None | $891.25 | $1,258.93 | $1,659.59 |
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 $138.04 Median $165.96 Typical High $380.19 | Professional | 52 · Reduced service | $138.04 | $165.96 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $67.61 Typical High $154.88 | Professional | 53 · Discontinued | $54.95 | $67.61 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $251.19 Typical High $575.44 | Professional | 54 · Surgery only | $204.17 | $251.19 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $50.12 Typical High $114.82 | Professional | 55 · Aftercare only | $41.69 | $50.12 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $33.88 Typical High $75.86 | Professional | 56 · Pre-op care only | $27.54 | $33.88 | $75.86 |
Where Kentucky sits
The same service costs 50.1 times more in Arkansas than in New York. 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· 50th of 51
$417
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.