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 $151.36 Median $173.78 Typical High $3,801.89 | Facility | None | $151.36 | $173.78 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $158.49 Typical High $204.17 | Professional | None | $151.36 | $158.49 | $204.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $154.88 Typical High $245.47 | Professional | None | $66.07 | $154.88 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $141.25 Median $169.82 Typical High $263.03 | Facility | None | $141.25 | $169.82 | $263.03 |
CareSource Setting Professional Modifier None Typical Low $165.96 Median $229.09 Typical High $275.42 | Professional | None | $165.96 | $229.09 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $831.76 | Facility | None | $338.84 | $338.84 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $295.12 Typical High $933.25 | Professional | None | $173.78 | $295.12 | $933.25 |
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 $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 $154.88 Median $269.15 Typical High $389.05 | Professional | None | $154.88 | $269.15 | $389.05 |
5 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 $75.86 Median $79.43 Typical High $93.33 | Professional | 52 · Reduced service | $75.86 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $32.36 Typical High $38.02 | Professional | 53 · Discontinued | $30.20 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $120.23 Typical High $141.25 | Professional | 54 · Surgery only | $112.20 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $23.99 Typical High $28.18 | Professional | 55 · Aftercare only | $22.39 | $23.99 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.85 Typical High $19.05 | Professional | 56 · Pre-op care only | $15.14 | $15.85 | $19.05 |
Where Kentucky sits
The same service costs 7.2 times more in Oklahoma than in Virginia. 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· 50th 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.