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 $21.38 Median $27.54 Typical High $794.33 | Facility | None | $21.38 | $27.54 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $27.54 Typical High $43.65 | Professional | None | $21.38 | $27.54 | $43.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $2,884.03 | Facility | None | $602.56 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.95 Median $26.30 Typical High $33.88 | Professional | None | $19.95 | $26.30 | $33.88 |
CareSource Setting Facility Modifier None Typical Low $22.39 Median $707.95 Typical High $1,258.93 | Facility | None | $22.39 | $707.95 | $1,258.93 |
CareSource Setting Professional Modifier None Typical Low $22.91 Median $32.36 Typical High $38.02 | Professional | None | $22.91 | $32.36 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $39.81 Typical High $363.08 | Facility | None | $34.67 | $39.81 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $30.20 Typical High $162.18 | Professional | None | $23.99 | $30.20 | $162.18 |
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 $23.99 Median $33.88 Typical High $52.48 | Professional | None | $23.99 | $33.88 | $52.48 |
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 $10.72 Median $12.30 Typical High $16.60 | Facility | 52 · Reduced service | $10.72 | $12.30 | $16.60 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.27 Median $4.90 Typical High $6.61 | Facility | 53 · Discontinued | $4.27 | $4.90 | $6.61 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $15.85 Median $18.62 Typical High $24.55 | Facility | 54 · Surgery only | $15.85 | $18.62 | $24.55 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.16 Median $3.72 Typical High $4.90 | Facility | 55 · Aftercare only | $3.16 | $3.72 | $4.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.45 Typical High $3.31 | Facility | 56 · Pre-op care only | $2.14 | $2.45 | $3.31 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.72 Median $13.18 Typical High $15.49 | Professional | 52 · Reduced service | $10.72 | $13.18 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $5.37 Typical High $6.17 | Professional | 53 · Discontinued | $4.27 | $5.37 | $6.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.85 Median $19.95 Typical High $23.44 | Professional | 54 · Surgery only | $15.85 | $19.95 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.98 Typical High $4.68 | Professional | 55 · Aftercare only | $3.16 | $3.98 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.63 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.14 | $2.63 | $3.09 |
Where Kentucky sits
The same service costs 3.5 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· 49th of 51
$30.20
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.