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 $63.10 Median $190.55 Typical High $794.33 | Facility | None | $63.10 | $190.55 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $173.78 Typical High $213.80 | Professional | None | $63.10 | $173.78 | $213.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $177.83 Typical High $245.47 | Professional | None | $61.66 | $177.83 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $57.54 Median $69.18 Typical High $109.65 | Facility | None | $57.54 | $69.18 | $109.65 |
CareSource Setting Professional Modifier None Typical Low $61.66 Median $95.50 Typical High $112.20 | Professional | None | $61.66 | $95.50 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $831.76 | Facility | None | $120.23 | $120.23 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $213.80 Typical High $1,122.02 | Professional | None | $69.18 | $213.80 | $1,122.02 |
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 $74.13 Median $213.80 Typical High $407.38 | Professional | None | $74.13 | $213.80 | $407.38 |
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 $30.90 Median $38.90 Typical High $123.03 | Facility | 52 · Reduced service | $30.90 | $38.90 | $123.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.59 Median $15.85 Typical High $48.98 | Facility | 53 · Discontinued | $12.59 | $15.85 | $48.98 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $46.77 Median $58.88 Typical High $186.21 | Facility | 54 · Surgery only | $46.77 | $58.88 | $186.21 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.33 Median $11.75 Typical High $37.15 | Facility | 55 · Aftercare only | $9.33 | $11.75 | $37.15 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.76 Typical High $24.55 | Facility | 56 · Pre-op care only | $6.31 | $7.76 | $24.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $56.23 Typical High $107.15 | Professional | 52 · Reduced service | $30.90 | $56.23 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $22.39 Typical High $42.66 | Professional | 53 · Discontinued | $12.59 | $22.39 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $83.18 Typical High $162.18 | Professional | 54 · Surgery only | $46.77 | $83.18 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $16.98 Typical High $32.36 | Professional | 55 · Aftercare only | $9.33 | $16.98 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $11.22 Typical High $21.38 | Professional | 56 · Pre-op care only | $6.31 | $11.22 | $21.38 |
Where Kentucky sits
The same service costs 4.5 times more in Oklahoma than in Nebraska. 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· 49th of 51
$178
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.