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 $35.48 Median $70.79 Typical High $138.04 | Facility | None | $35.48 | $70.79 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $70.79 Typical High $114.82 | Professional | None | $35.48 | $70.79 | $114.82 |
Ambetter Setting Professional Modifier None Typical Low $42.66 Median $85.11 Typical High $138.04 | Professional | None | $42.66 | $85.11 | $138.04 |
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 $45.71 Median $54.95 Typical High $77.62 | Professional | None | $45.71 | $54.95 | $77.62 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $67.61 Median $85.11 Typical High $114.82 | Professional | 50 · Both sides | $67.61 | $85.11 | $114.82 |
CareSource Setting Facility Modifier None Typical Low $37.15 Median $54.95 Typical High $87.10 | Facility | None | $37.15 | $54.95 | $87.10 |
CareSource Setting Professional Modifier None Typical Low $54.95 Median $79.43 Typical High $107.15 | Professional | None | $54.95 | $79.43 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $69.18 Typical High $79.43 | Facility | None | $34.67 | $69.18 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $79.43 Typical High $467.74 | Professional | None | $39.81 | $79.43 | $467.74 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $33.11 Typical High $40.74 | Professional | None | $31.62 | $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 $53.70 Median $81.28 Typical High $123.03 | Professional | None | $53.70 | $81.28 | $123.03 |
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 $17.78 Median $35.48 Typical High $43.65 | Facility | 52 · Reduced service | $17.78 | $35.48 | $43.65 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.08 Median $14.13 Typical High $17.38 | Facility | 53 · Discontinued | $7.08 | $14.13 | $17.38 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.37 Median $10.47 Typical High $13.18 | Facility | 55 · Aftercare only | $5.37 | $10.47 | $13.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.55 Median $7.08 Typical High $8.71 | Facility | 56 · Pre-op care only | $3.55 | $7.08 | $8.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $17.78 Median $34.67 Typical High $43.65 | Professional | 52 · Reduced service | $17.78 | $34.67 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $13.80 Typical High $17.38 | Professional | 53 · Discontinued | $7.08 | $13.80 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $10.23 Typical High $13.18 | Professional | 55 · Aftercare only | $5.37 | $10.23 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $6.92 Typical High $8.71 | Professional | 56 · Pre-op care only | $3.55 | $6.92 | $8.71 |
Where Kentucky sits
The same service costs 3.8 times more in Alaska than in Virginia. 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
$67.61
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.