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 $87.10 Median $120.23 Typical High $151.36 | Facility | None | $87.10 | $120.23 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $120.23 Typical High $138.04 | Professional | None | $87.10 | $120.23 | $138.04 |
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 $83.18 Median $125.89 Typical High $194.98 | Professional | None | $83.18 | $125.89 | $194.98 |
CareSource Setting Facility Modifier None Typical Low $104.71 Median $131.83 Typical High $194.98 | Facility | None | $104.71 | $131.83 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $104.71 Typical High $154.88 | Facility | None | $34.67 | $104.71 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $134.90 Typical High $794.33 | Professional | None | $95.50 | $134.90 | $794.33 |
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 $87.10 Median $120.23 Typical High $199.53 | Professional | None | $87.10 | $120.23 | $199.53 |
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 $43.65 Median $60.26 Typical High $75.86 | Facility | 52 · Reduced service | $43.65 | $60.26 | $75.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $17.38 Median $24.55 Typical High $30.20 | Facility | 53 · Discontinued | $17.38 | $24.55 | $30.20 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $64.57 Median $91.20 Typical High $114.82 | Facility | 54 · Surgery only | $64.57 | $91.20 | $114.82 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.88 Median $18.20 Typical High $22.91 | Facility | 55 · Aftercare only | $12.88 | $18.20 | $22.91 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.71 Median $12.02 Typical High $15.14 | Facility | 56 · Pre-op care only | $8.71 | $12.02 | $15.14 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $56.23 Typical High $69.18 | Professional | 52 · Reduced service | $43.65 | $56.23 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $22.91 Typical High $27.54 | Professional | 53 · Discontinued | $17.38 | $22.91 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $85.11 Typical High $102.33 | Professional | 54 · Surgery only | $64.57 | $85.11 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $16.98 Typical High $20.42 | Professional | 55 · Aftercare only | $12.88 | $16.98 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $11.22 Typical High $13.80 | Professional | 56 · Pre-op care only | $8.71 | $11.22 | $13.80 |
Where Kentucky sits
The same service costs 3.7 times more in Alaska than in Florida. 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· 47th of 51
$123
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.