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 $57.54 Median $81.28 Typical High $102.33 | Facility | None | $57.54 | $81.28 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $81.28 Typical High $117.49 | Professional | None | $57.54 | $81.28 | $117.49 |
Ambetter Setting Professional Modifier None Typical Low $79.43 Median $93.33 Typical High $141.25 | Professional | None | $79.43 | $93.33 | $141.25 |
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 $48.98 Median $58.88 Typical High $79.43 | Professional | None | $48.98 | $58.88 | $79.43 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $72.44 Median $89.13 Typical High $120.23 | Professional | 50 · Both sides | $72.44 | $89.13 | $120.23 |
CareSource Setting Facility Modifier None Typical Low $61.66 Median $85.11 Typical High $107.15 | Facility | None | $61.66 | $85.11 | $107.15 |
CareSource Setting Professional Modifier None Typical Low $61.66 Median $85.11 Typical High $102.33 | Professional | None | $61.66 | $85.11 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $85.11 Typical High $109.65 | Facility | None | $34.67 | $85.11 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $91.20 Typical High $512.86 | Professional | None | $63.10 | $91.20 | $512.86 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $40.74 | Professional | None | $33.11 | $33.11 | $40.74 |
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 $63.10 Median $91.20 Typical High $134.90 | Professional | None | $63.10 | $91.20 | $134.90 |
8 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 $28.84 Median $40.74 Typical High $51.29 | Facility | 52 · Reduced service | $28.84 | $40.74 | $51.29 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $11.48 Median $16.22 Typical High $20.42 | Facility | 53 · Discontinued | $11.48 | $16.22 | $20.42 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.71 Median $12.30 Typical High $15.14 | Facility | 55 · Aftercare only | $8.71 | $12.30 | $15.14 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.75 Median $8.13 Typical High $10.23 | Facility | 56 · Pre-op care only | $5.75 | $8.13 | $10.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $40.74 Typical High $51.29 | Professional | 52 · Reduced service | $28.84 | $40.74 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $16.22 Typical High $20.42 | Professional | 53 · Discontinued | $11.48 | $16.22 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $12.30 Typical High $15.14 | Professional | 55 · Aftercare only | $8.71 | $12.30 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $8.13 Typical High $10.23 | Professional | 56 · Pre-op care only | $5.75 | $8.13 | $10.23 |
Where Kentucky sits
The same service costs 3.7 times more in Alaska 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
$74.13
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.