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 $794.33 Median $1,380.38 Typical High $2,630.27 | Facility | None | $794.33 | $1,380.38 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $1,380.38 Typical High $1,380.38 | Professional | None | $660.69 | $1,380.38 | $1,380.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,511.38 | Facility | None | $954.99 | $2,884.03 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $199.53 Typical High $239.88 | Professional | None | $169.82 | $199.53 | $239.88 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $257.04 Median $302.00 Typical High $363.08 | Professional | 50 · Both sides | $257.04 | $302.00 | $363.08 |
CareSource Setting Facility Modifier None Typical Low $194.98 Median $2,570.40 Typical High $4,897.79 | Facility | None | $194.98 | $2,570.40 | $4,897.79 |
CareSource Setting Professional Modifier None Typical Low $194.98 Median $257.04 Typical High $316.23 | Professional | None | $194.98 | $257.04 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,089.30 Typical High $2,344.23 | Facility | None | $602.56 | $2,089.30 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $3,548.13 Typical High $3,548.13 | Professional | None | $724.44 | $3,548.13 | $3,548.13 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $181.97 | Professional | None | $44.67 | $44.67 | $181.97 |
United Setting Facility Modifier None Typical Low $741.31 Median $1,479.11 Typical High $5,128.61 | Facility | None | $741.31 | $1,479.11 | $5,128.61 |
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 $331.13 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $331.13 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $131.83 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $489.78 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $97.72 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $66.07 | $138.04 | $138.04 |
Where Kentucky sits
The same service costs 67.6 times more in Oklahoma than in Montana. 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
$209
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.