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 $97.72 Median $123.03 Typical High $1,778.28 | Facility | None | $97.72 | $123.03 | $1,778.28 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $112.20 Typical High $128.82 | Professional | None | $97.72 | $112.20 | $128.82 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $9,549.93 Typical High $11,220.18 | Facility | None | $758.58 | $9,549.93 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $141.25 Typical High $173.78 | Professional | None | $120.23 | $141.25 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $104.71 Median $1,318.26 Typical High $2,344.23 | Facility | None | $104.71 | $1,318.26 | $2,344.23 |
CareSource Setting Professional Modifier None Typical Low $107.15 Median $117.49 Typical High $162.18 | Professional | None | $107.15 | $117.49 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $204.17 Typical High $691.83 | Facility | None | $34.67 | $204.17 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $141.25 Typical High $831.76 | Professional | None | $102.33 | $141.25 | $831.76 |
Molina Setting Professional Modifier None Typical Low $173.78 Median $177.83 Typical High $239.88 | Professional | None | $173.78 | $177.83 | $239.88 |
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 $112.20 Median $134.90 Typical High $208.93 | Professional | None | $112.20 | $134.90 | $208.93 |
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 $48.98 Median $54.95 Typical High $61.66 | Professional | 52 · Reduced service | $48.98 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $22.39 Typical High $24.55 | Professional | 53 · Discontinued | $19.95 | $22.39 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $83.18 Typical High $91.20 | Professional | 54 · Surgery only | $74.13 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $16.60 Typical High $18.20 | Professional | 55 · Aftercare only | $14.79 | $16.60 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $11.22 Typical High $12.30 | Professional | 56 · Pre-op care only | $9.77 | $11.22 | $12.30 |
Where Kentucky sits
The same service costs 4.0 times more in Alaska than in Delaware. 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· 40th of 51
$141
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.