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 $61.66 Median $66.07 Typical High $794.33 | Facility | None | $61.66 | $66.07 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $70.79 Typical High $79.43 | Professional | None | $66.07 | $70.79 | $79.43 |
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 $51.29 Typical High $60.26 | Professional | None | $42.66 | $51.29 | $60.26 |
CareSource Setting Facility Modifier None Typical Low $426.58 Median $549.54 Typical High $812.83 | Facility | None | $426.58 | $549.54 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $134.90 Typical High $489.78 | Facility | None | $34.67 | $134.90 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $87.10 Typical High $371.54 | Professional | None | $67.61 | $87.10 | $371.54 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
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 $64.57 Median $74.13 Typical High $131.83 | Professional | None | $64.57 | $74.13 | $131.83 |
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 $33.11 Median $35.48 Typical High $38.90 | Professional | 52 · Reduced service | $33.11 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $14.13 Typical High $15.49 | Professional | 53 · Discontinued | $13.18 | $14.13 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $53.70 Typical High $57.54 | Professional | 54 · Surgery only | $50.12 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.72 Typical High $11.48 | Professional | 55 · Aftercare only | $10.00 | $10.72 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $7.08 Typical High $7.76 | Professional | 56 · Pre-op care only | $6.61 | $7.08 | $7.76 |
Where Kentucky sits
The same service costs 5.5 times more in Arkansas than in Kentucky. 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· 51st of 51
$60.26
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.