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 $61.66 Median $75.86 Typical High $75.86 | Facility | None | $61.66 | $75.86 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $75.86 Typical High $79.43 | Professional | None | $61.66 | $75.86 | $79.43 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.49 Median $15.85 Typical High $25.70 | Professional | None | $13.49 | $15.85 | $25.70 |
CareSource Setting Facility Modifier None Typical Low $77.62 Median $1,288.25 Typical High $1,949.84 | Facility | None | $77.62 | $1,288.25 | $1,949.84 |
CareSource Setting Professional Modifier None Typical Low $87.10 Median $1,348.96 Typical High $2,398.83 | Professional | None | $87.10 | $1,348.96 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
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 $602.56 Median $4,786.30 Typical High $31,622.78 | Facility | None | $602.56 | $4,786.30 | $31,622.78 |
United Setting Professional Modifier None Typical Low $74.13 Median $87.10 Typical High $134.90 | Professional | None | $74.13 | $87.10 | $134.90 |
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 $30.90 Median $38.02 Typical High $39.81 | Professional | 52 · Reduced service | $30.90 | $38.02 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $15.14 Typical High $15.85 | Professional | 53 · Discontinued | $12.30 | $15.14 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $11.22 Typical High $12.02 | Professional | 55 · Aftercare only | $9.33 | $11.22 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $7.59 Typical High $7.94 | Professional | 56 · Pre-op care only | $6.17 | $7.59 | $7.94 |
Where Kentucky sits
The same service costs 12.6 times more in California 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
$19.50
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.