How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $63.10 Median $77.62 Typical High $77.62 | Facility | None | $63.10 | $77.62 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $77.62 Typical High $257.04 | Professional | None | $63.10 | $77.62 | $257.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $70.79 Typical High $79.43 | Professional | None | $60.26 | $70.79 | $79.43 |
CareSource Setting Facility Modifier None Typical Low $79.43 Median $1,318.26 Typical High $1,995.26 | Facility | None | $79.43 | $1,318.26 | $1,995.26 |
CareSource Setting Professional Modifier None Typical Low $89.13 Median $1,380.38 Typical High $2,454.71 | Professional | None | $89.13 | $1,380.38 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
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 Professional Modifier None Typical Low $79.43 Median $91.20 Typical High $144.54 | Professional | None | $79.43 | $91.20 | $144.54 |
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 $31.62 Median $38.90 Typical High $128.82 | Professional | 52 · Reduced service | $31.62 | $38.90 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $15.49 Typical High $51.29 | Professional | 53 · Discontinued | $12.59 | $15.49 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $11.48 Typical High $38.90 | Professional | 55 · Aftercare only | $9.55 | $11.48 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.76 Typical High $25.70 | Professional | 56 · Pre-op care only | $6.31 | $7.76 | $25.70 |
Where Kentucky sits
The same service costs 3.2 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
$70.79
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.