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 $44.67 Median $67.61 Typical High $91.20 | Facility | None | $44.67 | $67.61 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $63.10 Typical High $77.62 | Professional | None | $44.67 | $63.10 | $77.62 |
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 $42.66 Median $67.61 Typical High $114.82 | Professional | None | $42.66 | $67.61 | $114.82 |
CareSource Setting Facility Modifier None Typical Low $64.57 Median $81.28 Typical High $120.23 | Facility | None | $64.57 | $81.28 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $66.07 Typical High $77.62 | Facility | None | $34.67 | $66.07 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $75.86 Typical High $478.63 | Professional | None | $48.98 | $75.86 | $478.63 |
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 $43.65 Median $64.57 Typical High $107.15 | Professional | None | $43.65 | $64.57 | $107.15 |
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 $21.88 Median $33.88 Typical High $45.71 | Facility | 52 · Reduced service | $21.88 | $33.88 | $45.71 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.91 Median $13.80 Typical High $18.20 | Facility | 53 · Discontinued | $8.91 | $13.80 | $18.20 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $33.11 Median $51.29 Typical High $67.61 | Facility | 54 · Surgery only | $33.11 | $51.29 | $67.61 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.61 Median $10.23 Typical High $13.49 | Facility | 55 · Aftercare only | $6.61 | $10.23 | $13.49 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.47 Median $6.76 Typical High $9.12 | Facility | 56 · Pre-op care only | $4.47 | $6.76 | $9.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $30.90 Typical High $38.90 | Professional | 52 · Reduced service | $21.88 | $30.90 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $12.30 Typical High $15.49 | Professional | 53 · Discontinued | $8.91 | $12.30 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $45.71 Typical High $57.54 | Professional | 54 · Surgery only | $33.11 | $45.71 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $9.12 Typical High $11.48 | Professional | 55 · Aftercare only | $6.61 | $9.12 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $6.17 Typical High $7.76 | Professional | 56 · Pre-op care only | $4.47 | $6.17 | $7.76 |
Where Kentucky sits
The same service costs 3.4 times more in Alaska than in New York. 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· 46th of 51
$67.61
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.