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 $1,412.54 Typical High $5,248.07 | Facility | None | $794.33 | $1,412.54 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $1,513.56 | Professional | None | $1,174.90 | $1,412.54 | $1,513.56 |
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 $43.65 Median $43.65 Typical High $51.29 | Professional | None | $43.65 | $43.65 | $51.29 |
CareSource Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $21,379.62 | Facility | None | $1,412.54 | $1,412.54 | $21,379.62 |
CareSource Setting Professional Modifier None Typical Low $1,412.54 Median $2,041.74 Typical High $33,884.42 | Professional | None | $1,412.54 | $2,041.74 | $33,884.42 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $2,951.21 Typical High $3,311.31 | Facility | None | $831.76 | $2,951.21 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Professional | None | $7,585.78 | $7,585.78 | $7,585.78 |
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 $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $1,621.81 Median $2,137.96 Typical High $2,884.03 | Professional | None | $1,621.81 | $2,137.96 | $2,884.03 |
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 $588.84 Median $707.95 Typical High $758.58 | Professional | 52 · Reduced service | $588.84 | $707.95 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $281.84 Typical High $302.00 | Professional | 53 · Discontinued | $234.42 | $281.84 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $213.80 Typical High $223.87 | Professional | 55 · Aftercare only | $173.78 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $141.25 Typical High $151.36 | Professional | 56 · Pre-op care only | $117.49 | $141.25 | $151.36 |
Where Kentucky sits
The same service costs 147.9 times more in Alaska 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· 48th of 51
$1,175
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.