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 $42.66 Median $54.95 Typical High $416.87 | Facility | None | $42.66 | $54.95 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $51.29 Typical High $70.79 | Professional | None | $42.66 | $51.29 | $70.79 |
Ambetter Setting Professional Modifier None Typical Low $46.77 Median $57.54 Typical High $57.54 | Professional | None | $46.77 | $57.54 | $57.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $35.48 Median $46.77 Typical High $57.54 | Professional | None | $35.48 | $46.77 | $57.54 |
CareSource Setting Facility Modifier None Typical Low $38.90 Median $46.77 Typical High $74.13 | Facility | None | $38.90 | $46.77 | $74.13 |
CareSource Setting Professional Modifier None Typical Low $54.95 Median $60.26 Typical High $77.62 | Professional | None | $54.95 | $60.26 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $831.76 | Facility | None | $77.62 | $77.62 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $72.44 Typical High $288.40 | Professional | None | $47.86 | $72.44 | $288.40 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $70.79 Median $186.21 Typical High $1,148.15 | Facility | None | $70.79 | $186.21 | $1,148.15 |
United Setting Professional Modifier None Typical Low $44.67 Median $60.26 Typical High $102.33 | Professional | None | $44.67 | $60.26 | $102.33 |
10 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 Facility Modifier 52 · Reduced service Typical Low $21.38 Median $23.99 Typical High $28.84 | Facility | 52 · Reduced service | $21.38 | $23.99 | $28.84 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.51 Median $9.55 Typical High $11.48 | Facility | 53 · Discontinued | $8.51 | $9.55 | $11.48 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $31.62 Median $36.31 Typical High $42.66 | Facility | 54 · Surgery only | $31.62 | $36.31 | $42.66 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.31 Median $7.24 Typical High $8.51 | Facility | 55 · Aftercare only | $6.31 | $7.24 | $8.51 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.79 Typical High $5.75 | Facility | 56 · Pre-op care only | $4.27 | $4.79 | $5.75 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.38 Median $25.12 Typical High $28.84 | Professional | 52 · Reduced service | $21.38 | $25.12 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $10.00 Typical High $11.48 | Professional | 53 · Discontinued | $8.51 | $10.00 | $11.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $38.02 Typical High $42.66 | Professional | 54 · Surgery only | $31.62 | $38.02 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $7.59 Typical High $8.51 | Professional | 55 · Aftercare only | $6.31 | $7.59 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $5.01 Typical High $5.75 | Professional | 56 · Pre-op care only | $4.27 | $5.01 | $5.75 |
Where Kentucky sits
The same service costs 4.8 times more in Alaska 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
$50.12
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.