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 $229.09 Typical High $3,801.89 | Facility | None | $186.21 | $229.09 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $229.09 Typical High $245.47 | Professional | None | $186.21 | $229.09 | $245.47 |
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 $83.18 Median $162.18 Typical High $234.42 | Professional | None | $83.18 | $162.18 | $234.42 |
CareSource Setting Facility Modifier None Typical Low $263.03 Median $3,467.37 Typical High $5,888.44 | Facility | None | $263.03 | $3,467.37 | $5,888.44 |
CareSource Setting Professional Modifier None Typical Low $263.03 Median $4,073.80 Typical High $7,244.36 | Professional | None | $263.03 | $4,073.80 | $7,244.36 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $13,182.57 Typical High $14,791.08 | Facility | None | $436.52 | $13,182.57 | $14,791.08 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
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 $245.47 Median $338.84 Typical High $446.68 | Professional | None | $245.47 | $338.84 | $446.68 |
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 $114.82 Typical High $120.23 | Professional | 52 · Reduced service | $93.33 | $114.82 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $45.71 Typical High $48.98 | Professional | 53 · Discontinued | $37.15 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $173.78 Typical High $181.97 | Professional | 54 · Surgery only | $141.25 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $34.67 Typical High $36.31 | Professional | 55 · Aftercare only | $28.18 | $34.67 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $22.91 Typical High $24.55 | Professional | 56 · Pre-op care only | $18.62 | $22.91 | $24.55 |
Where Kentucky sits
The same service costs 9.5 times more in Arkansas than in Kentucky. 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· 51st of 51
$200
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.