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 $22.91 Median $47.86 Typical High $851.14 | Facility | None | $22.91 | $47.86 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $45.71 Typical High $60.26 | Professional | None | $22.91 | $45.71 | $60.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $3,801.89 Typical High $11,220.18 | Facility | None | $575.44 | $3,801.89 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.92 Median $42.66 Typical High $61.66 | Professional | None | $26.92 | $42.66 | $61.66 |
CareSource Setting Facility Modifier None Typical Low $24.55 Median $39.81 Typical High $61.66 | Facility | None | $24.55 | $39.81 | $61.66 |
CareSource Setting Professional Modifier None Typical Low $25.12 Median $33.88 Typical High $41.69 | Professional | None | $25.12 | $33.88 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $43.65 Typical High $53.70 | Facility | None | $34.67 | $43.65 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $54.95 Typical High $295.12 | Professional | None | $26.30 | $54.95 | $295.12 |
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 $28.18 Median $44.67 Typical High $77.62 | Professional | None | $28.18 | $44.67 | $77.62 |
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 $11.48 Median $23.99 Typical High $28.18 | Facility | 52 · Reduced service | $11.48 | $23.99 | $28.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.57 Median $9.55 Typical High $11.22 | Facility | 53 · Discontinued | $4.57 | $9.55 | $11.22 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $17.38 Median $36.31 Typical High $42.66 | Facility | 54 · Surgery only | $17.38 | $36.31 | $42.66 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.47 Median $7.24 Typical High $8.51 | Facility | 55 · Aftercare only | $3.47 | $7.24 | $8.51 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.29 Median $4.79 Typical High $5.62 | Facility | 56 · Pre-op care only | $2.29 | $4.79 | $5.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $11.48 Median $20.89 Typical High $27.54 | Professional | 52 · Reduced service | $11.48 | $20.89 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $8.32 Typical High $10.96 | Professional | 53 · Discontinued | $4.57 | $8.32 | $10.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $17.38 Median $31.62 Typical High $40.74 | Professional | 54 · Surgery only | $17.38 | $31.62 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $6.31 Typical High $8.13 | Professional | 55 · Aftercare only | $3.47 | $6.31 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $4.17 Typical High $5.50 | Professional | 56 · Pre-op care only | $2.29 | $4.17 | $5.50 |
Where Kentucky sits
The same service costs 3.3 times more in Alaska than in New Jersey. 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
$42.66
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.